AIM To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.METHODS Scopus, Cochrane databases, MEDLINE/Pub Med, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy(EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerS imonian and Laird models with the odds ratio(OR) to assess adenoma detection, cecal intubation rate, and complications performed. RESULTS Nine studies(n = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma(OR = 1.49, 95%CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection(OR = 2.34 95%CI: 1.63-3.36; P < 0.001). There was no significant difference in cecal intubation rates between the EACgroup and standard colonoscopy(OR = 1.26, 95%CI: 0.70-2.27, I2 = 0%; P = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.CONCLUSION The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy. AIM To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy. METHODS Scopus, Cochrane databases, MEDLINE / Pub Med, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meetings were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy (EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerS imonian and Laird models Compared to EC colonoscopy, procedures performed with EC had higher frequencies for adenoma (n = 5624 patients) were included in the analysis. OR = 1.49, 95% CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection (OR = 2.34 95% CI: 1.63-3.36; P <0.001). There was no significant difference in cecal i EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency (OR = 1.26, 95% CI: 0.70-2.27, I2 = 0%; P = for perforation. CONCLUSION The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.