OBJECTIVE： To evaluate therapeutic efficacy and safety of romethamine for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section， and to provide evidence-based reference in clinic. METHODS： Retrieved from CNKI，Wanfang database， VIP， CBM and PubMed， randomized controlled trials （RCT） about romethamine （trial group） vs. routine therapy alone，or routine therapy combined （with） misoprostol （control group） for assisted prevention of intraoperative and postoperative hemorrhage in placenta previa puerperal during caesarean section were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. RESULTS： A total of 18 RCTs were included finally， involving 1 824 patients. Results of Meta-analysis showed that intraoperative bleeding amount [MD＝－138.16，95％CI（－162.97，－113.35），P＜0.001]， bleeding amount 2 h after surgery [MD＝－134.33，95％CI（－149.87，－118.79），P＜0.001]， bleeding amount 24 h after surgery [MD＝－150.78，95％CI（－171.20，－130.37），P＜0.001] and the incidence of postoperative hemorrhage [OR＝0.22，95％CI（0.10，0.47），P＜0.001] in trial group were significantly lower than control group， with statistical significance. The incidence of ADR in trial group was significantly lower than control group [OR＝2.37，95％ CI（1.09，5.17），P＝0.03]， with statistical significance. CONCLUSIONS： Romethamine can reduce intraoperative and postoperative bleeding amount in placenta previa puerperal during caesarean section， and do not increase the occurrence of ADR.