OBJECTIVE： To systematically evaluate the efficacy and safety of hydrotalcite combined with omeprazole for gastric ulcer， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Embase， Medline， the Cochrane library， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about hydrotalcite combined with omeprazole （trial group） versus omeprazole alone （control group） for gastric ulcer during the database establishment to Aug. 2018. After data extraction of included literatures met inclusion criteria， and quality evaluation with Cochrane evaluator manual 5.0.1， Meta-analysis was performed for response rate， the incidence of ADR， recurrence rate of gastric ulcer bleeding， needed time of clinical symptom improvement and hospitalization stays by using Rev Man 5.3 statistical software. RESULTS： A total of 16 RCTs， involving 1 802 patients were included. The results of Meta-analysis showed that response rate [RR＝1.24， 95％CI（1.19，1.29）， P＜0.001] of trial group was significantly higher than that of control group； recurrence rate of gastric ulcer [RR＝0.27，95％CI（0.17，0.45），P＜0.001]， clinical symptom improvement time [MD＝－2.04，95％CI（－2.25，       －1.83），P＜0.001] and hospitalization time [MD＝－4.25，95％CI（－4.55，－3.95），P＜0.001] of trial group were significantly lower or shorter than those of control group， with statistical significance. There was no statistical significance in the incidence of ADR [RR＝0.68，95％CI（0.46，1.02），P＝0.06] between 2 groups. CONCLUSIONS： Compared with omeprazole alone， hydrotalcite combined with omeprazole for gastric ulcer can obviously increase the clinical response rate， decrease the recurrence rate of gastric ulcer and shorten the needed time of clinical symptom improvement and hospitalization time， but do not increase the incidence of ADR.