Background: Recurrence rates and predictors of recurrence for solid pseudopapillary neoplasm of pancreas (SPN) remain unclear, and this makes it challenging to determine the duration of follow up in clinic. Aim of the current study was to perform a systematic review and meta- analysis to determine the recurrence rates, and identify factors associated with recurrence in patients with SPN. Methods: A Pubmed search was conducted to identify studies with SPN published during the last 15 years: 09/2002-09/2017. 877 articles were identified. Studies reporting on case series of patients with SPN with follow up >5 years were included. Isolated case reports, duplicate publications, and patients presenting with metastatic disease were excluded to prevent bias in calculation of recurrence rates. PRISMA 2009 guidelines were followed. STATA 14.2 was used for statistical analysis. Results: 104 studies with 2579 patients were included in the final qualitative analysis. 67 patients developed recurrence during follow up. Pooled estimates from studies with a sample size >20 (N = 33) noted an overall recurrence rate of 2% (95% CI 1 – 3%, Fig. 1). Time to recurrence was available for 48 patients. Median time to recurrence was 41 months (IQR 22 – 72 months, 71% recurred at ≤5years, 25% between >5 and ≤10 years & 4% at >10 years). Factors implicated in tumor recurrence include young age, large tumor size, perineural and lymphovascular invasion, peripancreatic invasion, R1 margin, tumor rupture, and high Ki-67. Conclusion: Our data suggests that 2% of patients with SPN experience recurrence after resection. Majority of recurrence occur at ≤5 years, however 25% experience recurrence between 5 and 10 years. Further comparative analysis of patients who developed recurrence at ≤5 years vs >5years will be performed to identify factors associated with early vs delayed recurrences.