Objective To systematically evaluate the association between liver stiffness and the prognosis of patients with hepatocellular carcinoma (HCC). Methods We searched PubMed, Web of Science, Wanfang, and CNKI databases for relevant literatures about the association between liver stiffness and the prognosis of HCC patients. Then we selected eligible literatures according to the including and excluding criteria, and we used Revman 5.3 software to perform statistical analysis. Results A total of 18 articles with 3 152 HCC patients were included. Meta results showed that HCC patients with higher liver stiffness had shorter recurrence free survival time [HR=1.09, 95%CI (1.04, 1.14), P<0.000 1], lower 5-year recurrence free survival rate [OR=2.67, 95%CI (2.08, 3.44), P<0.000 01], higher 5-year recurrence rate [OR=0.19, 95%CI (0.09, 0.38), P<0.000 01], shorter overall survival time [HR=2.42, 95%CI (1.45, 4.03), P=0.000 7], and lower 5-year overall survival rate [OR=2.89, 95%CI (2.18, 3.83), P<0.000 01]. Conclusion Liver stiffness measurement can predict the prognosis of HCC patients.