Objective：To provide an evidence-based reference for clinic by systematically evaluating the curative effect and safety of elemene for malignant ascites.Methods：Searched databases as CNKI，Wanfang Database，VIP Database，CBM，PubMed and web of science，for randomized controlled trials(RCT)of elemene for malignant ascites and extracted data of studies accorded with the inclusion criteria.Selected literature，extracted data and evaluated quality of literature according to the inclusive and exclusive criteria.The meta-analysis was conducted via RevMan 5.3 statistical software.Results：Seven pieces of RCT literature were included，339 cases of patients in total.The effectiveness of the meta-analysis results showed that the short term effective rate of patients in the experiment group[OR=1.78，95%CI(1.07，2.95)，P＜0.01]was significantly higher than that in the chemotherapy group.Safety showed that the myelosuppression incidence[OR=0.05，95%CI(0.01，0.20)，P＜0.01]，and the gastrointestinal reaction rate[OR=0.05，95%CI(0.02，0.12)，P＜0.01]of patients in the experiment group were lower than those in the control group，while the fever incidence was higher than that in the control group[OR=3.97，95%CI(1.82，8.67)，P＜0.01]and no significant difference was found in the comparison of the local pain reaction incidence between the experiment group and the control group[OR=3.03， 95%CI(0.71， 12.96)，P＜0.05].Conclusion：Elemene has significant effect in treating malignant ascites，which also can reduce adverse reactions of gastrointestinal caused by chemotherapy and reduce toxic and side effects of myelosuppression.However，elemene has the risk of causing fever so it should be used according to the specific condition of patients.