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A meta-analysis of the impact of monensin on metabolism of dairy cattle was conducted following a search of the literature. A total of 59 studies with monensin feeding in dairy cattle were identified in which 30 papers and 45 trials contained metabolic data. The beta-hydroxybutyrate (BHBA) data were obtained from over 4,000 cows and 115 trial sites. Data for each trial were extracted and analyzed using meta-analysis software in Stata. Estimated effect sizes of monensin were calculated on blood concentrations of BHBA, acetoacetate, nonesterified fatty acids (NEFA), glucose, cholesterol, urea, calcium, insulin, and milk urea. Monensin use in lactating dairy cattle significantly reduced blood concentrations of BHBA 13%, acetoacetate 14%, and NEFA 7%. Monensin increased glucose 3% and urea 6%. Monensin had no significant effect on cholesterol, calcium, milk urea, or insulin. Heterogeneity was significant for BHBA and cholesterol [I(2) (measure of variation beyond chance) = 37 and 54%, respectively]; therefore, random effects models were used for those analytes. Publication bias existed with the monensin effect on BHBA, with a tendency for studies to be published if there was a significant reduction in this ketone. Meta-regression analysis of the effect sizes obtained from the metabolic data showed that method of delivery, timing of administration, stage of lactation, and diet were influential in modifying effect size of monensin treatment. Use of top dress or delivery via a controlled release capsule reduced the magnitude of effect on BHBA (coefficient +0.353); however, top dress use compared with controlled release capsule or total mixed ration enhanced the monensin effect on glucose (coefficient +0.296). There was a greater impact with monensin on reducing BHBA in early lactation (coefficient -0.151) and in pasture-based trials (coefficient -0.194). Use of monensin in both the pre- and postcalving periods was associated with an enhanced impact on NEFA (coefficient -0.254). Monensin had less impact on serum glucose in the pre-calving time period (coefficient -0.237). These findings demonstrate an improvement in the energy metabolism of dairy cows supplemented with monensin.