OBJECTIVE： To systematically review the efficacy and safety of adjuvant therapy of Compound kushen injection for pleural effusion of elderly patients with malignant cancer， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， EMBase， Medline， Cochrane library， CJFD， VIP and Wanfang database， RCTs about therapeutic efficacy （response rate， complete remission rate， rate of life quality improvement） and safety （the incidence of chest pain and gastrointestinal ADR） of cisplatin injection， IL-2 injection or other drugs combined with Compound kushen injection （trial group） versus cisplatin injection， IL-2 injection or other drugs alone （control group） in the treatment of pleural effusion of elderly patients with malignant cancer were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction of clinical studies met inclusion criteria and quality evaluation with Cochrane system evaluator manual 5.1.0. RESULTS： There were totally 7 RCTs， involving 522 patients. Results of Meta-analysis showed that the response rate [RR＝1.33， 95％CI （1.20，1.48）， P＜0.001]， complete remission rate [RR＝1.77， 95％CI （1.40，2.24）， P＜0.001]， rate of life quality improvement [RR＝4.61， 95％CI （2.68， 7.93）， P＜0.001] in trial group were significantly higher than control group. The incidence of chest pain [RR＝0.35， 95％CI （0.21，0.59）， P＜0.01] and gastrointestinal ADR [RR＝0.32， 95％CI （0.20，0.51）， P＜0.001] in trial group were significantly lower than control group， with statistical significance. CONCLUSIONS： Cisplatin， IL-2 or other drugs combined with Compound kushen injection versus cisplatin injection， IL-2 injection or other drugs alone in treatment of elderly malignant pleural effusion can improve response rate， complete remission rate and quality of life， at the same time， can reduce the occurrence of chest pain and gastrointestinal ADR significantly.