A meta-analysis of cohort studies was conducted to assess the association between serum uric acid (SUA) levels and incidence of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM).A comprehensive search was conducted to identify eligible studies. The fixed or random effect pooled measure was selected based on between-study heterogeneity. Dose–response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression.Twelve studies with fifteen results were included involving 6340 cases and 62,834 participants. The pooled multivariate-adjusted relative risk (RR) (95%CI) of IFG and T2DM for the highest vs. lowest level of SUA was 1.54 (1.41–1.68), I 2 =42.2%. The association was consistent and significant across subgroup analysis. A nonlinear relationship was found of SUA levels with incidence of IFG and T2DM (P<0.01), and the multivariate-adjusted RRs (95%CI) of IFG and T2DM were 1.02 (0.95–1.10), 1.04 (0.94–1.15), 1.10 (0.99–1.22), 1.25 (1.16–1.35), 1.43 (1.31–1.55), 1.50 (1.38–1.63) and 1.49 (1.34–1.67) for 2.5, 3.5, 4.5, 5.5, 6.5, 7.5 and 8.5mg/dl of SUA. The RR (95%CI) of T2DM for the highest vs. lowest level of SUA was 1.67 (1.51–1.86), and a nonlinear relationship was also found between SUA levels and incidence of T2DM.SUA levels are positively associated with incidence of IFG and T2DM, and the association might be nonlinear.