Objective: To systematically evaluate the impacts of using enhanced recovery after surgery (ERAS) protocols on perioperative inflammatory response and immune function in patients with colorectal cancer undergoing elective surgery. Methods: The randomized controlled trials concerning using ERAS pathways in the setting of surgery for colorectal cancer were searched from several national and international online databases. The retrieval time was from inception of the database to April 2018. Quality assessment and data extraction of the selected studies were performed according to the Cochrane systematic review methods. Meta-analysis was performed by using RevMan 5.3 software. Results: Twenty-six studies were finally included, involving a total of 2 420 patients, with 1 185 cases in ERAS group and 1 235 cases in control group. The results of descriptive analysis showed that the postoperative levels of inflammatory factors were decreased and the time for postoperative recovery was shortened significantly in ERAS group compared with control group (all P<0.05). The results of pooled analysis showed that the percentage of CD4+T cells (WMD=0.85, 95% CI=0.21–1.49; WMD=2.85, 95% CI=1.76–3.94; WMD=1.52, 95% CI=0.42–2.62) and IgG levels (WMD=0.54, 95% CI=0.11–0.97; WMD=1.26, 95% CI=0.79–1.74; WMD=0.63, 95% CI=0.27–0.99) at postoperative day (POD) 1, 3 and 7, the percentage of CD3+ T cells (WMD=1.46, 95% CI=0.62–2.30; WMD=2.78, 95% CI=1.82–3.73) and IgA levels (WMD=0.14, 95% CI=0.07–0.22; WMD=0.29, 95% CI=0.22–0.36) at POD 1 and 3, and IgM levels (WMD=0.11, 95% CI=0.06–0.16) at POD 3 in ERAS group were significantly higher than those in control group (P<0.05); the incidence of wound infection (OR=0.52, 95% CI=0.31–0.85), pulmonary infection (OR=0.40, 95% CI=0.21–0.73), urinary tract infection (OR=0.15, 95% CI=0.04–0.54), postoperative intestinal obstruction (OR=0.34, 95% CI=0.13–0.87) and the overall complications (OR=0.40, 95% CI=0.28–0.56) in the ERAS group were significantly lower than those in control group (all P<0.05). Conclusion: ERAS protocols can be safely used in colorectal cancer patients undergoing elective surgery, which can inhibit the release of inflammatory mediators and help to maintain the stability of immune function during perioperative period, and thereby reduce the complications and promote early postoperative recovery.