Summary Objective This study aimed to conduct a systematic review of the diagnostic value of interleukin-27 (IL-27) for tuberculous pleurisy (TP). Methods Literature on IL-27 diagnosis of TP was retrieved and screened from six databases (four English databases and two Chinese databases). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve (SROC) were measured to assess accurately the comprehensive evaluation of IL-27 for TP. Results Eleven studies with a total of 1454 patients were identified in the analysis. The combined diagnostic value of IL-27 for TP was as follows: sensitivity of 0.95 (95% confidence interval [CI]: 0.93–0.97), specificity of 0.91 (95% CI: 0.89–0.92), positive likelihood ratio of 13.99 (95% CI: 7.01–27.93), negative likelihood ratio of 0.07 (95% CI: 0.05–0.10), diagnostic odds ratio of 275.20 (95% CI: 112.83–671.23) and area under the SROC of 0.9830. Conclusion IL-27 has an excellent diagnostic value for TP and could be used as a diagnostic biomarker for TP.