OBJECTIVE：To syst ematically evaluate the effectiveness and safety of ticagrelor versus clopidogrel in the treatment of acute coronary syndrome （ACS）patients in East Asia ，and to provide evidence-based references for clinical drug use. METHODS：Retrieved from Cochrane Library ，PubMed，Embase，CNKI，Wanfang database ，etc.，randomized controlled trials （RCTs）about ticagrelor （trial group ）versus clopidogrel （control group ）in the treatment of ACS patients in east Asia were collected. After literature screening and data extraction ，the quality of included literatures was evaluated by using biasrisk evaluation tool recommended by Co chrane system evaluation manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 5 RCTs were included ，with a total of 4 511 cases. Meta-analysis showed that the incidence of major adverse cardiovascular events [OR ＝0.85，95％CI（0.68，1.04），P＝0.12]，the incidence of death from cardiovascular causes [OR ＝0.76，95％CI（0.57，1.03），P＝0.08] and the incidence of stroke [OR ＝0.77，95％CI（0.48，1.24），P＝0.28]， without statistical significance. The incidence of major bleeding events [OR ＝1.54，95％CI（1.19，1.99），P＝0.001] and minor bleeding events [OR ＝1.80，95％ CI（1.40，2.32），P＜0.000 01] in trial group were significantly higher than control group. CONCLUSIONS：Ticagrelor is comparable to clopidogrel in reduce the major adverse cardiovascular events，death from cardiovascular causes and stroke in ACS patients in East Asian ，but it can increase the risk of major and minor bleeding events.