OBJECTIVES: We aimed to perform a systematic review (SR) with meta-analysis (MA) of all randomized controlled trials (RCT) comparing the efficacy of adjuvant chemotherapy with Gemcitabine (GEM) versus observation in patients with resected pancreatic cancer. METHODS: Several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. The primary endpoints were progression free survival (PFS) and overall survival (OS). The data extracted from the studies were combined by using Hazard Ratio (HR) with their corresponding Confidence Intervals of 95% (CI95%). RESULTS: Overall, 233 references were identified and screened. The final analysis included 2 trials comprising 472 patients evaluated. The proportion of patients that underwent surgery with curative intent (R0 or R1 resection) were similar between the studies as well as their ages and nodal status. The progression free survival was higher in the group of patients who were treated with adjuvant chemotherapy including GEM (fixed effect: HR=0.59, CI95%=0.50 to 0.70; p<0.00001) and no heterogeneity was found (Chi2 = 0.01, df = 1 (P=0.94); I2 = 0%). Overall survival was also higher in patients treated with GEM (fixed effect: HR=0.81, CI95%=0.67 to 0.98; p=0.03) yet again no heterogeneity was detected (Chi2 = 0.07, df = 1 (P=0.79); I2 = 0%). CONCLUSIONS: Adjuvant chemotherapy with Gemcitabine increased progression-free survival and overall survival of patients with resected pancreatic cancer.