Objective The study aims for an overall evaluation of the clinical value of differential diagnosis of solitary pulmonary nodule (SPN) with PET/CT integrated high resolution CT(HRCT) by using a meta-analysis. Methods Such databases as PubMed, EMBASE, Cochrane Library, Web of Science, VIP, Wanfang, CBM and CNKI were searched and screened for articles about using PET/CT and HRCT to diagnose SPN. The Metadisc1.4 and RevMan 5.0 software were used to analyze the data. Results A total of 8 articles were included finally, involving 538 nodules. The meta-analysis showed that, compared with reference standard, the summary sensitivity, specificity, diagnostic odds ratio and area under SROC curve for PET/CT, HRCT, PET/CT integrated HRCT diagnosing SPN were 0.91(0.86-0.94), 0.65(0.59-0.70), 23.08(13.48-39.52) and 0.8967; 0.88(0.80-0.93), 0.85(0.76-0.92), 45.86 (19.42-108.29) and 0.9351, 0.96(0.93- 0.98), 0.93(0.89-0.96), 306.49(125.93-745.94), 0.9844), respectively. Conclusion The comprehensive analysis by combining PET/CT and HRCT can greatly improve the sensitivity, specificity and accuracy in the diagnosis of SPN, and has superior diagnosis efficiency than use PET/CT or HRCT alone, and has more advantage in differentiation of benign and malignant SPN, so as to avoid unnecessary surgery.