The relation between psoriasis and colorectal cancer (CRC) was largely unclear. To investigate the association of psoriasis with CRC. A systematic review and meta-analysis of observational studies that examined the association of psoriasis with CRC was performed. We searched MEDLINE and Embase on March 24, 2020, for relevant studies. The Newcastle-Ottawa scale was used to evaluate the risk of bias of included studies. We conducted a random-effects model meta-analysis and subgroup analysis according to sex. We included 9 cohort studies with 10,544,609 individuals. We found a significantly increased risk for CRC in patients with psoriasis (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.08-1.24). Subgroups analysis according to sex found significantly increased risk for CRC in female patients with psoriasis (HR, 1.41; 95% CI, 1.16-1.72) but not in male patients (HR, 1.18; 95% CI, 0.92-1.50). No data on psoriatic arthritis. Patients with psoriasis have an increased risk for CRC. Gastroenterology consultation and colonoscopic examination are indicated for patients with psoriasis presenting with bowel symptoms. Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.