OBJECTIVES: To assess the risk of incident diabetes associated with antidepressant use among adults. METHODS: A systematic literature search was conducted to identify relevant studies in seven different electronic databases (PubMed, CINAHL, Cochrane Library, Dissertation Abstracts International/Proquest, Web of Science, Scopus, PsycINFO) along with cross-referencing from selected studies. Two independent reviewers identified the final studies to be included in the meta-analysis based on the following criteria: 1) observational studies; 2) adults ≥ 18 years of age; 3) antidepressant utilization; 4) published and unpublished  (dissertations and Master’s theses) studies; 5) English language studies only; 6) studies published from the inception of the respective databases to November 26, 2012; 7) minimum follow-up of 12 months from the start of antidepressant use. The primary outcome was incident diabetes. Random-effects models were used to determine the relationship between antidepressant use and incident diabetes. Incident diabetes was measured among individuals with no prior history of diabetes. Presence of diabetes was assessed by any of the following: self-report, physician diagnosis, ICD-9-CM code of 250.xx, fasting (>110mg/dl) and post-prandial (>140mg/dl) blood glucose measures, HbA1C value ≥7%, new prescription of oral antidiabetic medications or insulin. Egger’s regression test and Trim and Fill tests were used to detect the presence of any potential publication bias. Sensitivity analysis was conducted using the leave-one-out method.  RESULTS: Eight studies met the inclusion criteria. Random-effects models revealed that adults using antidepressants were more likely to develop diabetes compared to those not using antidepressants (Odds Ratio= 1.50, 95% CI-1.08-2.09; Hazards Ratio= 1.20, 95% CI-1.08-1.34). Sensitivity analyses revealed fair robustness. Results from the Egger’s regression test and Trim and Fill method revealed no evidence of publication bias.  CONCLUSIONS: Among adults, antidepressants are associated with the risk of developing incident diabetes. Further cause-and-effect studies are needed to confirm this association.