Objectives: Conflicting evidence exists on the association of all-cause mortality and serum alkaline phosphatase (ALP) levels. So, this study was aimed to understand the risk of all-cause mortality associated with elevated serum ALP levels.   Methods: An extensive literature was searched was performed in PubMed, and Embase database to retrieve all the epidemiological studies assessing the risk of all-cause mortality due to elevated serum ALP levels. The primary outcome was to compute the pooled risk of all-cause mortality due to elevated serum ALP levels. The secondary outcome was to compute the all-cause mortality risk due to dialysis modalities, and others. The certainty of findings was assessed using the GRADE criteria. Meta-analysis was performed using Review Manager v5.3.5.   Results: This meta-analysis was based on 15 studies constituting 395085 dialysis patients with a mean age of 56.39 ± 14.15 years. The pooled risk of all-cause mortality was higher for elevated ALP levels as compared to low ALP levels with a pooled risk ratio (RR) of 1.47 (95% CI: 1.33 – 1.62), p <0.00001. All-cause mortality risk was higher in peritoneal dialysis (PD) patients with a RR of 1.64 (95% CI: 1.53 – 1.76), p <0.00001 as compared to hemodialysis (HD) patients RR 1.44 (95% CI: 1.29 – 1.61), p <0.00001. Subgroup analysis revealed that studies with follow-up periods of more than 4 years and Asians had a higher risk of all-cause mortality RR 1.53 (95% CI: 1.18 – 1.98), p = 0.001 and RR 1.51 (95% CI: 1.28 – 1.78), p <0.00001 respectively.   Conclusions: Elevated serum ALP levels were found to be associated with a higher risk of all-cause mortality in both HD and PD patients. Future large epidemiological studies are warranted to confirm the findings by taking into account all the possible confounding factors.