OBJECTIVE：To systematically review the efficacy and safety of pirfenidone in the treatment of idiopathic pulmonary fibrosis（IPF），and provide evidence-based reference for clinical treatment. METHODS：Retrieved from Cochrane Library， PubMed，EMBase，CJFD，CBM，VIP Database and Wanfang Database，randomized controlled trials（RCT）about the efficacy and safety of pirfenidone（test group）versus placebo（control group）in the treatment of IPF were collected，and Meta-analysis was performed by using Rev Man 5.1.7 software after data extracting and quality evaluating by modified Jadad. RESULTS：Totally 4 RCTs were enrolled，involving 1 153 patients. Results of Meta-analysis showed the decrease value of lung capacity [WMD＝ 0.39，95％CI（0.16，0.61）， P＜0.001] and decrease value of the percentage of forced vital capacity to expected value [RR＝0.68， 95％CI（0.53，0.87），P＝0.002] in test group were lower than control group，there was significant difference between 2 groups； there was no significant difference in the lowest oxygen saturation [WMD＝0.53，95％ CI（－ 0.78，1.84），P＝0.43] between 2 groups，however，the results of subgroup analysis showed the remission degree of 1 200 mg/d PFD for the decrease of lowest oxygen saturation was superior to placebo group，there was significant difference between 2 groups [WMD＝1.72，95％CI（1.33，2.10）， P＜0.001]，but therewas no significant difference between the remission degree of 1800 mg/d and placebo ；and there was no significant difference in the incidence of adverse reactions between 2 groups [RR＝1.70，95％CI（0.46，6.31），P＝0.43]，but the incidence of photosensitivity veactions in test group was significantly higher than that of control group，there was significant difference [RR＝ 9.35，95％CI（4.23，20.67），P＜0.001]. CONCLUSIONS：The efficacy of pirfenidone in the treatment of IPF is good，but the incidence of photosensitivity reactions should be noticed.