Objective:To systematically evaluate the efficacy and safety of Guizhi Shaoyao Zhimu Decoction in treating rheumatoid arthritis. MethodsBased on the literature analysis and evaluation method of evidence-based medicine, we searched CNKI, VIP, CBM, Wanfang database and PubMed database, and collected the clinical evidence of Guizhi Shaoyao Zhimu Decoction in the treatment of rheumatoid arthritis with methotrexate (MTX) as control.The quality of the methodology was evaluated, the effective data were extracted,and the RevMan 5.3 software was used to analyze the data by meta analysis.  Results:A total of 8 RCTs were included. Meta analysis showed that the total effective rate of Guizhi Shaoyao Zhimu Decoction in the treatment of rheumatoid arthritis (RR=1.17,95% CI) was significantly better than that of MTX. The difference was statistically significant (P<0.01). Guizhi Shaoyao Zhimu Decoction was better than MTX(P<0.01)in shorting the time of morning stiffness, improving grip strength, reducing joint swelling, lowing rheumatoid factor(RF), with the low incidence of adverse reactions (OR=0.20,5%CI, P<0.01). However, there was no significant advantage in reducing joint tenderness and improving ESR compared with MTX.  Conclusion:Guizhi Shaoyao Zhimu Decoction has better curative effect on rheumatoid arthritis and the adverse reaction is lower than MTX. However, due to the low quantity and low quality of the literature included, the results of meta analysis were inevitably affected. Therefore, high-quality, large-sample double-blind randomized controlled trials are still needed to provide higher level of evidence.