【Objective】 To assess the diagnostic yield of vessel plus surface classification (VS classification) for detecting early gastric cancer (EGC). 【Methods】 A literature search of embase, Pubmed, Web of Science and Cochrane Library was performed and a meta-analysis was carried out using VS classification for diagnosing EGC under narrow band imaging with magnification endoscopy (NBI-ME). 【Results】 Five studies including 949 patients with 1090 lesions met the inclusion criteria. For diagnosing EGC, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and SROC area under the curve were 0.85 (95% CI: 0.79~0.89), 0.97 (95% CI: 0.96~0.98), 16.38 (95% CI: 4.94~54.26), 0.16 (95% CI: 0.09~0.32) and 0.9403. 【Conclusion】VS classification under NBI-ME is an accurate and precise means of diagnosing EGC.