ObjectivePsoriasis is a disease with an immunogenetic background in which cytokines have important effects on its prevalence and incidence. The present meta-analysis evaluated the relationship betweentumor necrosis factor-alpha(TNF-α) polymorphisms (rs361525,rs1800629,rs1799724,1800630, andrs1799964) and psoriasis risk in studies following Hardy-Weinberg equilibrium (HWE).Materials and methodsFour databases were searched to retrieve relevant studies reporting the distributions ofTNF-αpolymorphisms in psoriasis cases compared to controls. The effect sizes were the 95% confidence intervals (CIs) and odds ratios (ORs). Subgroup analysis, sensitivity analyses, publication bias, trial sequential analysis (TSA), and meta-regression were performed on the initial pooled results ofTNF-αpolymorphisms.ResultsThirty-six articles with 71 studies were included in the meta-analysis (twenty-six:rs361525, twenty-seven:rs1800629, nine:rs1799724, four:1800630, and five:rs1799964). The pooled ORs for −238 G/Ars361525 polymorphism were 2.33 (p< 0.00001), 2.79 (p< 0.0001), 2.35 (p< 0.00001), 2.44 (p< 0.00001), and 2.45 (p< 0.00001), as well as 1.57 (p< 0.00001), 1.98 (p= 0.01), 1.61 (p< 0.00001), 1.64 (p< 0.00001), and 1.79 (p< 0.00001) for −857 C/Trs1799724 polymorphism in allelic, homozygous, heterozygous, dominant, and recessive models, respectively. Ethnicity, psoriasis type, and sample size affected the pooled results ofrs361525,rs1800629, andrs1799724 polymorphisms. Based on TSA, there were just sufficient cases for −238 G/Ars361525 polymorphism in five genetic models and −857C/Trs1799724 polymorphism in allelic, heterozygous, and dominant models.ConclusionsThe A allele and GA and GG genotypes of −238 G/Ars361525 polymorphism and T allele, TT and CT genotypes of −857C/Trs1799724 polymorphism were related to increased risks in psoriasis cases. Well-designed studies (with no deviation from HWE in controls) with more cases are recommended in the future.