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To conduct a meta-analysis of published studies to determine the predictive validity of the MCAT on medical school performance and medical board licensing examinations.The authors included all peer-reviewed published studies reporting empirical data on the relationship between MCAT scores and medical school performance or medical board licensing exam measures. Moderator variables, participant characteristics, and medical school performance/medical board licensing exam measures were extracted and reviewed separately by three reviewers using a standardized protocol.Medical school performance measures from 11 studies and medical board licensing examinations from 18 studies, for a total of 23 studies, were selected. A random-effects model meta-analysis of weighted effects sizes (r) resulted in (1) a predictive validity coefficient for the MCAT in the preclinical years of r = 0.39 (95% confidence interval [CI], 0.21–0.54) and on the USMLE Step 1 of r = 0.60 (95% CI, 0.50–0.67); and (2) the biological sciences subtest as the best predictor of medical school performance in the preclinical years (r = 0.32 95% CI, 0.21–0.42) and on the USMLE Step 1 (r = 0.48 95% CI, 0.41–0.54).The predictive validity of the MCAT ranges from small to medium for both medical school performance and medical board licensing exam measures. The medical profession is challenged to develop screening and selection criteria with improved validity that can supplement the MCAT as an important criterion for admission to medical schools.