Background: The last decade has seen a number of developments in the methodology used in systematic reviews and meta-analysis of diagnostic test studies. It is of interest to ascertain whether such developments have permeated the wider research community and on which applications they are being deployed. Objective: To assess the uptake and deployment of the main methodological developments in the meta-analysis of diagnostic tests, and identify the tests and target disorders most commonly evaluated by meta-analysis. Methods: Eight databases (including MEDLINE and EMBASE) were searched. A six step algorithm was used to select studies on meta-analyses of diagnostic tests. Data were extracted on the study characteristics including statistical and quality assessment methods used. Appraisal was both quantitative and qualitative. Results: 237 studies met the inclusion criteria. The number of meta-analyses on diagnostic tests has increased over the last 5 years, but the uptake of new statistical methods lags behind. Pooling the sensitivity and specificity or using the summary ROC remain the preferred methods for analysis in 70% of studies, with the bivariate random effects and HSROC model being used in only 22% and 5% of studies respectively. In contrast between 2006 and 2008 the QUADAS tool was used in 40% of studies with even more citing it. Broadly radiological imaging was the most frequent category of tests analysed (36%), with infection (22%) and cancer (21%) being the most common categories of target disorder. Nearly 80% of the tests analysed were those normally used in a secondary care specialist setting. Conclusion: Although quality assessment in meta-analyses has improved with the introduction of QUADAS, uptake of the newer statistical methods is still lagging. Furthermore there is a preponderance of meta-analyses evaluating specialist tests in specialist settings, in contrast to where the majority of diagnostic tests are deployed in practice.