Objectives Fluorine-18 fluorodeoxyglucose (F-18-FDG) PET/MRI has been used in the diagnosis of head and neck carcinoma. The aim of this study was to systematically review and perform a meta-analysis of published data on the performance of 18F-PET/MRI in the diagnosis of head and neck carcinoma. Materials and methods We conducted a comprehensive review of the literature on the role of soft-based fusion and integrated F-18-FDG PET/MRI in the diagnosis of head and neck carcinoma. Pooled sensitivity, specificity, and area under the receiver-operating characteristic curve of softbased fusion and integrated F-18-FDG PET/MRI in the diagnosis of head and neck carcinoma were calculated. Results Ten studies comprising 421 patients, which included 1879 head and neck primary carcinoma and metastatic lesions, were included in this meta-analysis. F-18-FDG PET/MRI had a pooled sensitivity of 91%, a pooled specificity of 63%, and an area under the receiver-operating characteristic curve of 0.96 on a per lesion-based analysis in detecting head and neck carcinoma lesions. Soft-based fusion and integrated F-18-FDG PET/MRI had a pooled sensitivity of 92 and 90%, a pooled specificity of 53 and 87%, and an area under the receiver-operating characteristic curve of 0.95 and 0.96, respectively, on a per lesion-based analysis in detecting head and neck carcinoma lesions. Conclusion F-18-FDG PET/MRI demonstrated high sensitivity and moderate specificity in the diagnosis of head and neck carcinoma lesions. F-18-FDG PET/MRI is an accurate method in the diagnosis of head and neck carcinoma. Nucl Med Commun 36: 312-318 Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.