OBJECTIVE： To systematically review the clinical efficacy of Tibolone tablet in the treatment of senile vaginitis， and provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Medline， CJFD， CBM， VIP and Wangfang Database， randomized controlled trials （RCT） about Tibolone tablet in the treatment of senile vaginitis were collcted. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation. RESULTS： Totally 10 RCTs were enrolled， involving 909 patients. Results of Meta-analysis showed Tibolone tablet can significantly improve the cure rate of senile vaginitis [RR＝1.46，95％CI（1.32，1.61），P＜0.001]， maturation vaginal cell index score [SMD＝1.83，95％CI（1.65， 2.01），P＜0.001] and vaginal health score [SMD＝1.56，95％CI（1.21，1.92），P＜0.001]， reduce recurrence rate [RR＝0.07，95％CI（0.02，0.18），P＜0.001] and vaginitis score [SMD＝－1.44，95％CI（－1.79，－1.08），P＜0.001]. CONCLUSIONS： Tibolone tablet has good clinical efficacy in the treatment of senile vaginitis， it can improve the vaginal mucosa estrogen and vaginal environment， reduce recurrence rate.