Background MiR-146a has been widely studied in the pathogenesis of osteoarthritis (OA); however, the results are still controversial. Objective This meta-analysis analyzes the expression profile of miR-146a in various tissues of OA patients. Methods Public databases were searched for appropriate studies published up to September 1, 2021. A case–control study comparing the OA population and a non-OA healthy population was included. Results 26 articles were included in analysis. The results showed that the expression level of miR-146a in peripheral blood mononuclear cells (PBMCs) was significantly higher in OA patients than in controls (SMD: 1.23; 95% CI 0.08–2.37; p = 0.035) but not in plasma (SMD: 1.09; 95% CI − 0.06, 2.24; p = 0.064). The expression level of miR-146a in cartilage was also significantly higher in OA patients than in controls (SMD: 6.39; 95% CI 0.36, 12.4; p = 0.038) but not in chondrocytes (SMD: − 0.71; 95% CI − 4.15, 2.73; p = 0.687). The miR-146a level was significantly lower in synoviocytes in the OA population than in control patients (SMD: − 0.97; 95% CI − 1.68, − 0.26; p = 0.008). In synovial tissue, synovial fluid, and regulatory T cells, there was no significant difference. Conclusion The expression level of miR-146a in cartilage tissue and PBMCs was significantly higher in OA patients than in non-OA healthy controls. Due to the limitations of this study, more research is needed to confirm these results in the future. Trial registration: retrospectively registered.