Objective To systematically evaluate the accuracy of infrared ear thermometer in measuring the temperature of the elderly. Methods Literatures about the accuracy of infrared ear thermometer in measuring temperature of the elderly from 1988 to 2019 were retrieved from PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Database and Wanfang Database, ngoing studies were searched through ClinicalTrials.gov. Literatures were screened according to the strict inclusion and exclusion criteria, data were extracted, bias risk of included literatures was evaluated, Stata12.0 software was adopted to perform analysis. Results Eight literatures were included in analysis, including 3 literatures which had the mean and standard deviation of temperature in patients in normal temperature group and fever group, 1 literature compared data about ear temperature and axillary temperature in fever group, 4 literatures only compared data about ear temperature and axillary temperature in normal group; 5 literatures compared the data of left ear and right ear temperature. Meta-analysis showed that there was no significant difference in ear temperature and axillary temperature in both normal temperature group and fever group (both P>0.05); there was no significant difference between left ear temperature and right ear temperature (P>0.05). Conclusion The accuracy of infrared ear thermometer is good, and it can be used as the best screening tool to determine the initial temperature of the elderly.