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It has been reported that the encapsulated miRNAs from exosomes are potential biomarkers of tumors prognosis. Yet, the results are controversial, so it is obliged to do a meta-analysis to reach a definite conclusion.Studies were searched for published in PubMed, Embase, and Web of Science databases until April 20, 2018. A meta-analysis was conducted to appraise the role of exosomal miRNAs in prognosis of cancer patients.The different exosomal miRNAs expression was remarkably related to overall survival (OS) (hazard ratio [HR] = 2.02, 95% confidence interval [CI]: 1.84–2.21) and disease-free survival (DFS) (HR = 2.43, 95% CI: 1.86–3.17) of cancer patients. High exosomal miR-21 expression was associated with poor OS (HR = 2.59; 95% CI: 1.71–3.90) and DFS (HR = 1.84; 95% CI: 1.37–2.47). High exosomal miR-451a expression was associated with poor OS (HR = 4.81; 95% CI: 2.33–9.93) and DFS (HR = 2.64; 95% CI: 1.62–4.31). High exosomal miR-1290 expression was associated with poor OS (HR = 1.73; 95% CI: 1.29–2.33). Low exosomal miR-638 expression was associated with poor OS (HR = 2.25; 95% CI: 1.46–3.46).The expression levels of exosomal miRNAs, particularly miR-21, miR-451a, miR-1290, and miR-638 could strongly predict prognosis of solid tumor patients and might be a potential target for tumor treatment.