ObjectiveThe X-ray repair cross complementing group 1 (XRCC1) gene is involved in DNA repair. Defects in DNA repair may lead to head and neck squamous cell carcinomas (HNSCCs). Several researches have focused on relationship between XRCC1 Arg399Gln genetic polymorphism with HNSCC's prognosis with conflicting results. So, the aim of the present meta-analysis was evaluation of relationship between XRCC1 Arg399Gln polymorphism with HNSCC's prognosis. MethodsPublished articles up to July 2022 were systematically searched through international databases like PubMed, Web of Science, Scopus, etc. I2 test was applied to assess the heterogeneity. Data were analyzed using random effects model. Funnel plots and Egger test were applied for assessing publication biases. The hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated for evaluation of relationship between the polymorphism with HNSCC's prognosis. ResultsFifteen articles were included for the systematic review. Six of those articles were considered for inclusion in meta-analysis. The different forms of XRCC1 Arg399Gln polymorphism had not significant association with overall survival (OS) under varied genetic models (heterozygous: Ln (HR) = 0.02, 95 % CI= (−0.33,0.37), p-value = 0.90; homozygous: Ln (HR) = 0.33, 95 % CI= (−0.03,0.69), p-value = 0.07 and dominant: Ln (HR) = 0.06, 95 % CI = (−0.17,0.28), p-value = 0.62). Analysis showed that variants of the polymorphism had no significant relationship with OS in Asian and Caucasian ethnicity under dominant model (Ln (HR) = 0.14, 95 % CI= (−0.13,0.40), p-value = 0.31; Ln (HR) = -0.01, 95 % CI= (−0.41,0.38), p-value = 0.96). ConclusionDifferent forms of XRCC1 Arg399Gln polymorphism had no significant relationship with HNSCC's prognosis under varied genetic models and based on different ethnicity.