Objective: Hyperuricemia increases the risk of gout and cardiovascular diseases. Obesity increase the risk of hyperuricemia while weight loss (>5 kg) has been reported to decrease urate. The effects of orlistat on serum uric acid is still controversial. The aim of this meta-analysis was to evaluate the influence of orlistat on serum uric acid level in adults. Methods: Relevant studies, published up to May 2020, were searched systematically through PubMed/Medline, Scopus, and Google Scholar. All relevant randomized controlled clinical trials were included. Meta-analysis was performed using random-effect model. Subgroup analysis, sensitivity analysis, and meta-regression were also carried out Results: Overall 7 trials (9 dataset) that enrolled 1786 subjects were included. Orlistat showed in significant change in serum uric acid level (Difference in means: -17.661μmol, 95% CI: -31.615 to -3.707, P=0.01). A low heterogeneity observed across the studies (I^2 = 25.119%). After categorizing studies on the basis of duration and sample size the effect of orlistat on serum uric acid was significant. The results of meta-regression were showed that significant relationships were not found between orlistat and serum uric acid in duration of intervention. Conclusion: We found a significant reduction in serum uric acid following orlistat therapy in adults.