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ObjectiveThere are some indications of regional differences in the association between fish consumption and clinical outcomes. We aimed to test the linear and potential non-linear dose–response relationships between fish consumption and risk of all-cause and cardiovascular (CVD) mortality, and possible confounding by region.DesignSystematic review and dose–response meta-analysis.SettingSystematic search using PubMed and Scopus, from inception up to September 2016.SubjectsProspective observational studies reporting the estimates of all-cause and CVD mortality in relation to three or more categories of fish intake were included. Random-effects dose–response meta-analysis was conducted.ResultsFourteen prospective cohort studies (ten publications) with 911 348 participants and 75 451 incident deaths were included. A 20 g/d increment in fish consumption was significantly and inversely …