Background Despite the negative effect of sarcopenia on postoperative outcomes being well recognized in the elective setting, there remains a paucity of studies describing this phenomenon in the emergency laparotomy (EL) setting. This systematic review and meta‐analysis aimed to compare short‐ and long‐term postoperative outcomes following EL in patients with and without sarcopenia. Methods A systematic review using PRISMA guidelines was used to identify studies comparing perioperative outcomes following EL for patients with and without sarcopenia. A subsequent meta‐analysis was conducted. The following data were extracted from the included studies: patient demographics, pathology or type of operation performed for EL, post‐operative mortality at inpatient, 30‐day, 90‐day and 1‐year, and functional outcomes. A quality assessment of included studies was undertaken. Results Twelve studies reporting the outcomes of sarcopenia following EL were identified. Sarcopenia was significantly associated with higher 30‐day and 1‐year mortality rates following EL (OR 3.50, P < 0.01; OR 3.49, P < 0.01, respectively). Additionally, sarcopenia was significantly associated with unfavourable functional outcomes at discharge following emergency laparotomy (OR 2.44, p < 0.01). Conclusion Opportunistically identified on cross‐sectional imaging, sarcopenia is a valuable predictor of short‐ and long‐term morbidity and mortality following EL. Further studies are required to identify the most appropriate diagnostic criteria of sarcopenia and better define this physiological phenomenon. Forest plot of 30‐day mortality (a), 1‐year mortality (b), and discharge outcome (c) following emergency laparotomy in sarcopenic and non‐sarcopenic patients.