Background: Early diagnosis of COVID-19 has become one of the public health strategies for prevention and control of the disease by preventing its spread. The reference standard for confirmation of infection is the Reverse Transcriptase - Polymerase Chain Reaction RT-PCR. The aim is to estimate the diagnostic accuracy of rapid antigenic tests compared with RT-PCR for the diagnosis of SARS-CoV-2 infection in the general population, using a systematic review and meta-analysis of diagnostic accuracy.Methods: The literature search was conducted in February 2021 and updated in December 2021 studies involving diagnostic tests, evaluated in adults and pediatric population with suspected SARS-CoV-2 infection in which antigen testing was compared against RT-PCR for COVID 19 as a reference test were included. The title and abstract screening, risk of bias and data extraction were performed independently and in duplicate. Combined sensitivity and specificity of antigenic tests were estimated for different clinical utility scenarios. Data were analyzed using bivariate generalized linear bivariate mixed modelsFindings: A total of 121 articles were included. The combined sensitivity of the antigen test was 72.7% (95% CI 69.3% to 75.9%) and specificity 99.7% (95% CI 99.5% to 99.8%). Sensitivity ranged from 45.2% (95% CI 33.4% to 57.6%) to 92.8% (95% CI 90.2% to 94.8%), and specificity from 99.2% (95% CI 94.0% to 99.9%) to 99.9% (95% CI 99.7% to 99.9%) according to different subgroups.Interpretation: The performance of antigen testing was determined in adult and pediatric population, as well as in symptomatic subjects with different time intervals since symptom onset and in asymptomatic patients. This study analyzes the scenarios in which the test can be applied ensuring better diagnostic performance and, therefore, clinical utility. Its low sensitivity in scenarios of little or no symptomatology suggests that it should be interpreted with caution in asymptomatic patients.Funding Information: This project was not funded. Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The protocol was approved by the research committee of the School of Medicine and the ethics committee of the Fundación Universitaria Ciencias de la Salud (FUCS), which is stored in the Sistema Integrado de Información en Investigaciones (SIDI), under code 6858.