Aims: We aimed to assess the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for preoperative lymph node (LN) staging in newly diagnosed bladder cancer (BC) patients through a systematic review and meta-analysis. Patients and Methods: MEDLINE, Embase, and the Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for preoperative LN staging in newly diagnosed BC. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR–), and constructed summary receiver operating characteristic curves. Results: Across 14 studies (785 patients), the pooled sensitivity was 0.57 (95% CI: 0.49–0.64) and the pooled specificity was 0.92 (95% CI: 0.87–0.95). The LR syntheses gave an overall LR+ of 7.4 (95% CI: 4.4–12.3) and an LR– of 0.47 (95% CI: 0.39–0.56). The pooled diagnostic odds ratio was 16 (95% CI: 9–28). Conclusions: F-18 FDG PET/CT shows a low sensitivity and high specificity for the detection of metastatic LNs in patients with newly diagnosed BC.