BackgroundThe Controlling Nutritional Status (CONUT) score has proven to be a potential biomarker for determining the prognosis of patients with various types of cancer. Its value in determining the prognosis of patients with gynecological cancer, however, remains unknown. The present study was a meta-analysis that aimed to evaluate the prognostic and clinicopathological significance of the CONUT score in gynecological cancer.MethodsThe Embase, PubMed, Cochrane Library, Web of Science, and China National Knowledge Infrastructure databases were comprehensively searched through November 22, 2022. A pooled hazard ratio (HR), together with a 95% confidence interval (CI), was used to determine whether the CONUT score had prognostic value in terms of survival outcomes. Using odds ratios (ORs) and 95% CIs, we estimated the relationship between the CONUT score and clinicopathological characteristics of gynecological cancer.ResultsWe evaluated 6 articles, involving a total of 2,569 cases, in the present study. According to the results of our analyses, higher CONUT scores were significantly correlated with decreased overall survival (OS) (n= 6; HR = 1.52; 95% CI = 1.13–2.04;P= 0.006; I2 = 57.4%; Ph = 0.038) and progression-free survival (PFS) (n= 4; HR = 1.51; 95% CI = 1.25–1.84;P< 0.001; I2 = 0; Ph = 0.682) in gynecological cancer. Moreover, higher CONUT scores were significantly correlated with a histological grade of G3 (n= 3; OR = 1.76; 95% CI = 1.18–2.62;P= 0.006; I2 = 0; Ph = 0.980), a tumor size ≥ 4 cm (n= 2; OR = 1.50; 95% CI = 1.12–2.01;P= 0.007; I2 = 0; Ph = 0.721), and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage (n= 2; OR = 2.52; 95% CI = 1.54–4.11;P< 0.001; I2 = 45.5%; Ph = 0.175). The correlation between the CONUT score and lymph node metastasis, however, was not significant.ConclusionsHigher CONUT scores were significantly correlated with decreased OS and PFS in gynecological cancer. The CONUT score, therefore, is a promising and cost-effective biomarker for predicting survival outcomes in gynecological cancer.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12937-023-00863-8.