Backgroud The association between thrombomodulin gene (THBD) c.1418 C>T polymorphisms and the risk of venous thromboembolism (VTE) is controversial. The purpose of this meta-analysis was to evaluate THBD c.1418 C>T polymorphisms and the risk of VTE. Methods Computer searches were performed on the CNKI, Wanfang database, VIP database, PubMed, Embase, Web of Science, and Cochrane Library databases. The retrieval time limit was from the establishment of the database to June 2022. Case-control studies and cohort studies of THBD c.1418 C>T polymorphisms associated with VTE were included. The literature was screened according to inclusion and exclusion criteria, data extraction and literature quality evaluation. Meta-analysis was performed using STATA 14.0 software. Results A total of 12 literature were included, including 2980 cases in the case group and 3649 cases in the control group. The meta-analysis results showed no significant association of the THBD c.1418 C> T polymorphisms with the occurrence of VTE (T vs C: OR = 1.17, 95%CI = 0.93–1.48; TT vs CT+CC: OR = 1.00, 95%CI = 0.75–1.33; TT+CT vs CC: OR = 1.22, 95%CI = 0.94–1.59). Subgroup analyses revealed an increased risk of VTE in Asian populations due to THBD c.1418 C>T polymorphisms (T vs C: OR = 1.48, 95%CI = 1.06–2.07; TT vs CT+CC: OR = 1.80, 95%CI = 1.13–2.85; TT+CT vs CC: OR = 1.58, 95%CI = 1.07–2.32). THBD c.1418 C>T polymorphisms increased the risk of DVT (T vs C: OR = 1.51, 95%CI = 1.24–1.85; TT vs CT+CC: OR = 1.85, 95%CI = 1.10–3.12; TT+CT vs CC: OR = 1.64, 95%CI = 1.28–2.11). THBD c.1418 C>T polymorphisms reduced the risk of VTE in non-Asian populations (TT vs CT+CC: OR = 0.66, 95%CI = 0.45–0.98). Conclusion THBD c.1418 C>T polymorphisms is associated with VTE in Asian population, which may be a factor in the occurrence of VTE in Asian population. THBD c.1418 C>T polymorphisms increases the risk of DVT. Given the limitations of this meta-analysis, the conclusions require being further supported by large-scale and high-quality studies.