Aim. To review and compare the PON-1 arylesterase activity between coronary artery disease (CAD) and non-CAD patients. Methods. Data were obtained by searching MEDLINE and Scopus for all investigations published between January 1, 2000 and March 1, 2021 comparing PON-1 arylesterase activity between CAD and controls. Results. Twenty studies, based on 5417 patients, met the inclusion criteria and were included in the analysis. A random effect model revealed that PON-1 arylesterase activity was significantly lower in the CAD group compared to controls (
SMD
=
–
0.587
,
95
%
CI
=
−
0.776
to -0.339,
p
<
0.0001
,
I
2
=
92.3
%
). In CAD patients, the PON-1 arylesterase activity was significantly higher among CAD patients without diabetes mellitus (DM) compared to those with diabetes (SMD: 0.235, 95% CI: 0.014 to 0.456,
p
=
0.03
,
I
2
=
0
%
). Conclusions. PON-1 activity is significantly lower in CAD patients, and those without DM presented a significantly higher PON-1 arylesterase activity.