A recent publication from the International Journal of Colorectal Disease, examined colorectal anastomoses in patients with colorectal cancer. This meta-analysis aimed to evaluate whether Indocyanine green fluorescence angiography (ICG-FA) could prevent anastomotic leakage (AL) in colorectal surgery. The study included 1806 patients in the ICG group and 2231 patients in the control group. The pooled incidence of AL in ICG group was 3.8% compared with 7.8% in control group. There was a significant difference in AL rate with or without use of ICG-FA (OR 0.44; 95% CI 0.33–0.59; P < 0.00001). Reoperation rates were 2.6% and 6.9% in ICG and control groups, respectively. The results revealed that ICG-FA reduced risks of AL, reoperation, and overall complications for colorectal cancer patients undergoing colorectal surgery.