Objective to evaluate the association of DPYD gene polymorphisms with the 5-fluorouracil (5-FU) severe toxicity in Asian cancer patients reported in the literature. We conducted a meta-analysis of the published literature to summarize evidence for DPYD gene polymorphisms associated with an increased risk of severe 5-fluorouracil toxicity in Asian cancer patients. Relevant literature was identified using the PubMed and Cochrane databases on April 11, 2014 . Combined risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated in a fixed-effects model or a random-effects model according to results of heterogeneity test. All analyses were performed by RevMan 5.2 and Stata 10.0 software. A total of 4 clinical studies retrieved in our study, including 304 cancer patients with DPYD gene polymorphism and received 5FU-based chemotherapy. Overall, DPYD gene polymorphism was not associated with the increased risk of 5-FU severe toxicity (RR = 0.35; 95% CI 0.34, 0.41, p=0.0001). This meta-analysis suggested that polymorphisms of the DPYD gene might not associate with an increased risk for severe toxic response to 5- FU in the Asian population.