OBJECTIVE： To systematically review the efficacy and safety of amifostine in preventing chemotherapy-induced peripheral neurotoxicity （CIPN）， and provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， EMBase， Cochrane Library， CJFD， Wanfang and VIP Database， randomized controlled trials （RCT） about amifostine combined with chemotherapy （test group） versus chemotherapy alone （control group） in preventing CIPN were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad score. RESULTS： Totally 20 RCTs were included， involving 1 552 patients. Results of Meta-analysis showed， the total incidence of CIPN [RR＝0.57，95％CI（0.45，0.72），P＜0.001] and incidence of serious CIPN [RR＝0.47，95％CI（0.32，0.69），P＜0.001] in test group were significantly lower than control group， the incidences of nausea [RR＝1.31，95％CI（1.03，1.67），P＝0.03]， vomiting [RR＝2.28，95％CI（1.14，4.54），P＝0.02] and hypotension [RR＝28.29，95％CI（10.53，76.04），P＜0.001] were significantly higher than control group， with statistic significance； and there was no significant difference in objective response rate [RR＝1.08，95％CI（0.98，1.19）， P＝0.14]. CONCLUSIONS： Amifostine can effectively prevent the incidence of CIN and does not affect chemotherapy efficacy， whereas can increase the incidence of nausea and vomiting and easily induce hypotension.