Although many studies have investigated the association of the APOA5 -1131T/C polymorphism with coronary artery disease (CAD), definite conclusions have not been drawn. To understand the effects of the APOA5 -1131T/C polymorphism on the risk of developing CAD, we performed an updated meta-analysis in the Chinese population. Relevant studies published till April 2015 were identified from databases such as PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure, and Chinese Biology Medicine. A total of 19 studies including 3983 patients and 4358 controls were involved in this meta-analysis. The crude OR with 95%CI was calculated to assess the strength of the association. With the pooled data from the studies included in this meta-analysis, we found a significant association between the APOA5 -1131T/C polymorphism and CAD risk in the Chinese population (C vs T: OR = 1.34, 95%CI = 1.16-1.54; CC vs TT: OR = 1.73, 95%CI = 1.30-2.30; CC vs TT and TC: OR = 1.51, 95%CI = 1.17-1.95; CC vs TC: OR = 1.30, 95%CI = 1.03-1.65). Stratified analyses according to the geographical location and source of controls revealed significantly increased risk in South China and in population-based studies. In conclusion, our meta-analysis provides substantial evidence that the APOA5 -1131T/C polymorphism might contribute to CAD development in the Chinese population.