OBJECTIVE： To systematically review the efficacy of α-lipoic acid versus epalrestat in the treatment of diabetic peripheral neuropathy （DPN）， and provide evidence-based reference for clinic. METHODS： Retrieved from CJFD， CBM， VIP， Wanfang Database and PubMed， randomized controlled trials （RCT） about α-lipoic acid versus epalrestat in the treatment of DPN were collected， and the study was screened by inclusion and exclusion criteria. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane software. RESULTS： Totally 6 RCTs were enrolled， involving 408 patients. Results of Meta-analysis showed， compared with epalrestat， there were no significant differences in the total effective rate [RR＝0.98，95％Cl（0.84，1.15），P＝0.81]， motor nerve conduction velocity [median nerve：MD＝1.02，95％Cl（－1.10，3.14）， P＝0.34； common peroneal nerve： MD＝0.23，95％Cl（－1.11，1.58），P＝0.73] and sensory nerve conduction velocity [median nerve： MD＝1.10，95％Cl（－0.39，2.59），P＝0.15； common peroneal nerve： MD＝0.95，95％Cl（－1.47，3.36），P＝0.44] in α-lipoic acid group. CONCLUSIONS： The efficacy of α-lipoic acid is similar to epalrestat in the treatment of DPN， as well as the motor nerve conduction velocity and sensory nerve conduction velocity of median nerve or common peroneal nerve.