The aim of this study was to assess the association between polymorphisms and ischemic clinical outcomes. We searched the electronic database for articles on the relationship of SNPs and ischemic events in patients with coronary artery disease (CAD) up to October 2020. A total of 9914 patients with CAD from six studies focusing on 12 SNPs of PEAR1 were included in this study. The A allele of rs12041331 were associated with ischemic events (odds ratio: 1.40; 95% CI: 1.04-1.88; p = 0.03). The AA homozygotes of rs2768759 was related to a higher risk of ischemic events than carriers of the C allele (odds ratio: 2.08; 95% CI: 1.09-3.97; p = 0.03). PEAR1 rs12041331 and rs2768759 are significantly associated with ischemic events in patients with CAD.