The findings suggested that the serum NSE levels in sepsis patients with a favorable outcome (n = 509) were significantly lower than those in sepsis patients with an unfavorable outcome (n = 255) (Z = 5.44, P < 0.001, MD = − 5.34, 95%CI − 7.26 to − 3.42) in both the meta-analysis reporting mortality (Z = 4.30, P < 0.001, MD = − 5.38, 95%CI − 7.28 to − 2.93) and the meta-analysis reporting adverse neurological outcomes (Z = 12.32, P < 0.001, MD = − 5.95, 95%CI − 6.89 to − 5.00). The gene discussed is ENO2; the disease is Sepsis.