Abstract：Objective To systematically evaluate the safety and efficiency of cefathiamidine in clinical applications with meta-analysis. Methods The databases of Pubmed, Embase, Cochrane Library, CNKI, VIP, Wanfang, and CBM were retrieved for collecting randomized controlled trials (RCTs) about the safety of cefathiamidine in clinical applications. The included RCTs were given strict reviews and the data were extracted. Then, the ones that met the criterion were given Meta-analysis by using the Rev Man 5.3 software. Results 35 papers involving 1913 cases as the treatment group and 1870 cases as the control group were included. The result of Meta-analysis showed that the rate of adverse reactions in cefathiamidine group was significantly lower than that in the control group [RR=0.35, 95% CI (0.27, 0.45), P<0.00001], which showed that the difference was statistically significant. In terms of curative effects, the efficiency was higher than that of the control group. Conclusion Compared with other similar drugs, clinical safety of cefathiamidine were relatively good, but the clinical applications should pay more attention to the adverse reactions. And further studies need more high quality randomized double-blind controlled trials of verification.