OBJECTIVE： To systematically evaluate the effectiveness and safety of escitalopram and duloxetine in the treatment of depression， and provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Wanfang database， VIP， CNKI and CBM， randomized controlled trials （RCTs） about escitalopram （trial group） and duloxetine （control group） in the treatment of depression were collected. Meta-analysis was conducted by using Rev Man 5.3 software after data extraction and quality evaluation according to bias risk assessment tool recommended by system evaluator manual 5.3. RESULTS： Finally 25 RCTs were included， involving 2 621 patients. The results of Meta-analysis showed that there was no statistical significance in total response rate between 2 groups after 1， 2， 4， 6， 8 weeks of treatment or cure rate between 2 groups after 4， 6， 8 weeks of treatment （P＞0.05）. There was no statistical significance in total response rate [RR＝0.96，95％CI（0.88，1.05），P＝0.42] or cure rate [RR＝0.91，95％CI（0.78，1.06），P＝0.24] of female patients， as well as total response rate [RR＝0.96，95％CI（0.84，1.11），P＝0.61] or cure rate [RR＝0.90，95％CI（0.54，1.49），P＝0.69] of elderly patients between 2 groups. The incidence of constipation [RR＝0.59，95％CI （0.42，0.81），P＝0.001]， dry mouth [RR＝0.65，95％CI（0.51， 0.82），P＝0.000 4]， nausea [RR＝0.68，95％CI（0.56，0.83），P＝0.000 2] and decreased appetite [RR＝0.74，95％CI（0.55， 0.99），P＝0.04] in trial group were significantly lower than control group， with statistical significance. CONCLUSIONS： The effectiveness of escitalopram is similar to duloxetine in the treatment of depression， but the safety of escitalopram is better than duloxetine.