OBJECTIVE：To systematically evaluate the effectiveness and safety of dexmedetomidine versus other controlled hypotension drugs for functional nasal endoscopic surgery ，and to provide evidence-based reference for clinic. METHODS ： Retrieved from PubMed ，EBSCO，Springer，Ovid，Cochrane library ，CJFD，VIP，Wanfang database ，relevant journals and references of the included literature were also searched manually. RCTs about the effectiveness and safety of dexmedetomidine （trial group）versus other controlled hypotension drugs （control group ）for functional nasal endoscopic surgery were collected. After data extraction of included literatures ，quality evaluation with modified Jada quality scoring method ，Meta-analysis was performed by using Rev Man 5.3 software. RERULTS ：A total of 8 RCTs involving 497 patients were included. Meta-analysis results showed that compared with control group ，the ratio patients of hypotensive drug supplement [OR ＝－0.37，95％CI（0.21，0.65），P＝0.000 6] and the bleeding volume [MD ＝－77.74，95％CI（－99.52，－55.96），P＜0.001] of trial groups were lower ；hemodynamics such as MAP during extubation [MD ＝－13.40，95％CI（－16.24，－10.56），P＜0.001] and heart rate during extubation [MD ＝－33.13， 95％CI（－33.40，－26.87），P＜0.001] was more stable during extubation ；quality score of Fromme surgical field was higher [MD ＝ －0.80，95％CI（－0.96，－0.65），P＜0.001]；while the incidence of chill [OR ＝0.37，95％CI（0.18，0.75），P＝0.006]，nausea and vomit [OR ＝0.28，95％CI（0.14，0.59），P＝0.008] were lower. CONCLUSIONS ：Dexmedetomidine has a certain advantage than routine drugs for controlled hypotension during nasal endoscopic surgery ，and with better safety.