OBJECTIVE： To systematically review the efficacy and safety of lamivudine （LAM） combined with adefovir dipivoxil （ADV） versus entecavir （ETV）alone in the treatment of decompensated HBV-associated cirrhosis. METHODS： Retrieved from PubMed， Cochrane Library， CBM， CNKI， VIP and WangFang Database，  randomized controlled trails （RCT） about LAM combined with ADV （combination group） versus ETV （control group） in the treatment of decompensated HBV-associated cirrhosis were collected. Meta-analysis was performed by using Stata 11.0 software after data extraction and quality evaluation. RESULTS： Totally 13 RCTs were included， involving 972 patients. Results of Meta-analysis showed， there were no significant differences in the serum alanine transaminase （ALT）[SMD＝0.079，95％CI（－0.086，0.244），P＝0.348]， total bilirubin （TBIL） [SMD＝0.056， 95％CI（－0.118，0.230），P＝0.529]，ALB[SMD＝－0.020，95％CI（－0.494，0.454），P＝0.935]，HBV-DNA negative conversion rate [RR＝1.012，95％CI（0.950， 1.079），P＝0.710]， HBV e antigen （HBeAg） seroconversion rate [RR＝1.181，95％CI（0.969，1.439），P＝0.099]， HBeAg negative conversion rate [RR＝1.011，95％CI（0.860，1.189），P＝0.893]， follow-up 96 week liver function Child-Turcotte-Pugh score [SMD＝－0.063，95％CI（－0.299，0.173），P＝0.601]， virological breakthrough rate [RR＝1.562，95％CI（0.471， 5.178），P＝0.466]， mortality rate [RR＝1.198，95％CI（0.624，2.300），P＝0.587] and the incidence of adverse reactions [RR＝1.552，95％CI（0.618，3.900），P＝0.349]in 2 groups； follow-up 48 week liver function CTP score in combination group was significantly higher than control group， the difference was statistically significant [SMD＝0.352，95％CI（0.031，0.672），P＝0.031]. CONCLUSIONS： LAM combined with ADV shows similar efficacy and safety to ETV in the treatment of decompensated HBV-associated cirrhosis， but within short term （48 weeks）， ETV is more likely to inhibit the development of liver fibrosis of the chronic HBV patients， and even can reverse liver fibrosis and cirrhosis.