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Background: The vitamin D receptor (VDR) gene is a primary candidate gene for tuberculosis susceptibility, but results of previous studies are somewhat contradictory and underpowered. Thus, it is essential to further explore the association between VDR gene polymorphisms and risk of pulmonary tuberculosis (PTB). Methods: A systematic review and meta-analysis about the association between FokI, TaqI, ApaI and BsmI polymorphisms and PTB susceptibility was conducted. Statistical Package for Social Science (Version 13.0) and Review Manager (Version 4.2, The Cochrane Collaboration) were used to analyze the data reported in studies. Results: A total of 13 studies with 2262 cases and 2833 controls were involved in the FokI polymorphism, and the results showed Fokl polymorphism was associated with PTB susceptibility (allele f vs F: OR=1.12, 95% C/=[1.02, 1.23]; the additive effect model ff vs FF: OR=1.40, 95%C/=[1.10, 1.77]; the recessive genetic model ff vs Ff+FF: OR=1.39, 95%C/=[1.12, 1.71]). No significant associations were observed between TaqI (15 studies with 3031 cases and 3132 controls), ApaI (7 studies with 1495 cases and 1922 controls), BsmI (6 studies with 919 cases and 1250 controls) variants and PTB susceptibility. Conclusion: We found variant FokI polymorphism of VDR gene may play a risky role in PTB development, and the genetic model was presumed to be recessive.