Background: Chlamydia trachomatis (CT) is the most prevalent sexually transmitted infection (STI) globally but has been inadequately detected for intervention. Introduction of point-of-care tests (POCTs) for CT is critical for filling the intervention gaps. We conducted a systematical review and meta-analysis on diagnostic performance of POCTs for CT to assist in guiding the application of these assays in CT screening and detection. Methods: We searched PubMed/Medline and Embase databases, from January 2004 to Nov 2020, for studies reporting the performance of POCTs for identifying CT using specimens collected from urethral, vaginal, cervical, anorectal, or pharyngeal site or of urine. Two investigators independently screened and extracted data for controlling the quality of data extraction. Any discordant data were discussed to meet consensus by involvement of the third investigator. We only included studies with sufficient data to estimate sensitivity and specificity, and used laboratory-based nucleic acid amplification test (NAAT) as the reference standard. The main outcomes were pooled sensitivity, specificity, and diagnostic odds ratio (DOR) and their corresponding 95% confidence intervals (CIs). Summary estimates were calculated using a random-effects model and summary receiver operator curves (SROC) was generated using the Moses-Littenberg method. STATA 14.0 and Meta-DiSc 1.4 were used for statistical analysis. Findings: Of 2856 records identified, 37 studies (41,976 specimens) were included in the study, including 14 studies on evaluation of antigen detection (AD)-based and 23 on NAAT-based POCTs. The overall pooled sensitivity, specificity and DOR were 56% (95% CI 45%-67%), 99% (95% CI 98%-99%) and 86 (95% CI 46-163), respectively, for AD-based POCTs and corresponding values for NAAT-based POCTs were 94% (95% CI 92%-96%), 99% (95% CI 99%-100%) and 2,477 (95% CI 1,471-4,170), respectively. The pooled sensitivity of AD-based POCTs varied significantly across the types of specimens, 46% for cervical swabs (95% CI 37%-56%; range 22.7%-71.4%), 52% for vaginal swabs (95% CI 34%-70%; range 17.1%-86.8%) and 57% for male urine (95% CI 36%-75%; range 20.0%-82.6%). For NAAT-based POCTs, the pooled sensitivity was 93% (95% CI 87%-96%) for anorectal swabs, 94% (95% CI 92%-96%) for cervical swabs, 94% (95% CI 86%-98%) for vaginal swabs and 95% (95% CI 91%-97%) for urine specimens with a specificity ranging from 99% to 100%. Interpretation: NAAT-based POCTs for CT have a significantly better performance particularly in sensitivity for diagnosing the infection with CT than the AD-based POCTs. Funding Statement: The National Science and Technology Major Project for Belt and Road Initiative (2018ZX10101-001-001) and the Chinese Academy Medical Sciences Initiative for Innovative Medicine (2016-I2M-3-021) in China. Declaration of Interests: We declare no competing interests.