OBJECTIVE： To systematically evaluate therapeutic efficacy and safety of recombinant mutant human tumor necrosis factor （rmhTNF） versus pleural perfusion of cisplatin in the treatment of malignant pleural effusions， and to provide evidence-based reference in clinic. METHODS： Retrieved from PubMed， Cochrane Library， Web of Science， CJFD， Wanfang database， VIP and CBM， RCTs about rmhTNF （trial group） vs. cisplatin （control group） in the treatment of malignant pleural effusions were included. Meta-analysis was conducted by using Rev Man 5.3 statistical software after quality evaluation and data extraction with Cochrane system evaluator manual 5.3.0. RESULTS： A total of 7 RCTs were included， involving 478 patients. Meta-analysis showed that clinical total response rate of trial group [RR＝1.43，95％CI（1.27，1.62），P＜0.001] was significantly higher than that of control group， with statistical significance. There was no statistical significance in the incidence of gastrointestinal reaction [RR＝1.15，95％CI（0.73，1.80），P＝0.55]， chest pain [RR＝1.12，95％CI（0.73，1.73），P＝0.60]， fever[RR＝0.62，95％CI（0.35，1.08），P＝0.09] and myelosuppression[OR＝0.94，95％CI（0.57，1.54），P＝0.79] between trial group and control group. CONCLUSIONS： Pleural perfusion of rmhTNF is significantly better than cisplatin in the treatment of malignant pleural effusions. The incidences of gastrointestinal reaction， chest pain， fever and myelosuppression induced by rmhTNF were similar to those induced by cisplatin.