Increasing evidence has observed aberrant blood coagulation in the patients with cancers [5, 6]. As an established risk factor of blood hypercoagulability, the tumor cells release various cytokines to activate coagulation [7, 8]. D-dimer is a canonical marker of hypercoagulability and a common approach to evaluate the hypercoagulable state in clinical practice . Aberrant D-dimer has been detected in various cancers including colorectal cancer and several studies showed elevated D-dimer was correlated with poor survival of colorectal cancer [10, 11]. However, the inconsistent conclusion of pretreatment plasma D-dimer in colorectal cancer could not be ignored [12, 13]. Up to now, whether the pretreatment plasma D-dimer could be used for a predictive biomarker for the prognosis of colorectal cancer is controversial based on current evidence. Therefore, a comprehensive meta-analysis to combine the published studies is essential in order to reach a more convincing conclusion.