There were no significant associations in meta-regression and subgroup analysis of studies investigating endostatin in SSc patients and controls between the effect size and various patient and study characteristics.<h4>Discussion</h4>Therefore, the results of this systematic review and meta-analysis suggest that measuring endostatin can be useful in assessing the presence of SSc and specific complications, i.e., digital ulcers and pulmonary arterial hypertension, in these patients.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/prospero/, identifier CRD42024558174. The gene discussed is COL18A1; the disease is pulmonary arterial hypertension.