AbstractBackground and objective: Many studies have demonstrated and recommended that biomarkers such as Procalcitonin (PCT), C-reactive protein (CRP), and serum amyloid A (SAA) be used to diagnose sepsis in adults. However, there is limited literature on the efficacy and safety of serum amyloid A in diagnosing sepsis in adults. Therefore, this study aims to establish the safety and effectiveness of SAA in diagnosing sepsis in adults.Methods: A thorough search was done across five electronic databases, Google Scholar, PubMed, Science Direct, EMBASE, and Cochrane, to acquire the relevant articles exploring the diagnosis of sepsis in adults using SAA. The data extracted include the concentration levels of SAA in the patients’ blood and the sensitivity and specificity of SAA. In the end, a meta-analysis was done on the included studies using Cochrane Review Manager Software version 5.4.Results: Ten primary articles were retrieved comprising RCTs and retrospective and prospective study designs. The outcomes of the included studies and meta-analysis indicated high concentration levels of SAA in the serum group than in the control, CRP, and PCT groups. The differences were statistically significant for control and CRP but insignificant with PCT, (MD 78.01, 95% CI 37.93 to 118.09; I2 = 98%; P < 0.0001), (MD 5.68, 95% CI 0.57 to 10.78; I2 = 99%; P = 0.03), and (MD -94.25, 95% CI -212.65 to 24.16; I2 = 92%; P = 0.12), respectively. Comparison of SAA and CRP levels in sepsis expression was insignificant at various post-diagnosis days (MD 1.64, 95% CI -2.01 to 5.30; I2 = 97%; P = 0.38). The studies included in this article revealed high sensitivity and specificity of SAA compared to CRP, PCT, and other biomarkers.Conclusion: This study demonstrates that serum amyloid A can also be used as a biomarker in diagnosing and predicting adult sepsis due to its high sensitivity, specificity, and concentration levels in expressing viral and bacterial infections.