RESULTS: A total of 19 studies (August 2009 to April 2016) with 1571 patients were selected. 12 of these studies had assessed the diagnostic performance of cryobiopsies for lung parenchymal lesions (10 studies included patients with diffuse parenchymal lung disease, one study included pulmonary nodules and one study included immunocompromised patients with infiltrates). Meta-analysis for these 12 studies revealed an inverse variances weighted diagnostic yield of 79.6% (95% CI 71-85, P <0.001). 7 out of these 12 studies had provided adequate information about mean sizes of biopsy samples. The pooled mean biopsy sample size was 25.6 mm2 (95% CI 15.2-37.9, P <0.001). 4 studies only assessed diagnostic utility of cryobiopsies for endobronchial lesions. For these studies, the inverse variance weighted diagnostic yield was 93.9% (95% CI 91.1-95.9, P<0.001). Finally, 3 studies evaluated the utility of cryobiopsies for evaluation of lung allografts. For these, the pooled mean biopsy sample size was 50.3 mm2 (95% CI 15.9-84.6, P=0.004). All but two studies provided safety data. Overall complication rate was 16%. Most of these complications included self-limited bleeds and small pneumothoraces requiring no further intervention. Only 1 patient died after cryobiopsy.