Case-control studies on the association between N-acetyltransferase 2 (NAT2) genotype and gastric cancer have provided either controversial or inconclusive results. In order to clarify the influence of NAT2 acetylation status on gastric cancer risk, a meta-analysis was undertaken. The primary outcome measure was the odds ratio (OR) for the risk of gastric cancer associated with the NAT2 genotype. The overall result showed that there was no statistically significant association between NAT2 status and gastric cancer risk (slow acetylation vs. rapid acetylation, OR = 1.10, 95 % confidence interval (CI) 0.97-1.25, p = 0.12). In the analysis stratified by East Asian ethnicity, a significant association was found between gastric cancer and the NAT2 genotype (slow acetylation vs. rapid acetylation, OR = 1.33, 95 % CI 1.11-1.59, p = 0.002). Our pooled data suggest that the NAT2 acetylation status has an effect on the risk of gastric cancer among East Asian populations.