OBJECTIVE： To systematically review the clinical efficacy of Angong niuhuang pill in the adjuvant treatment of ischemic stroke in acute phase，and provide evidence-based reference for clinic. METHODS： Retrieved from CJFD， VIP， Wanfang Database， PubMed and the Cochrane Library， randomized controlled trails （RCT） or quasi-random control trials （qRCT） about Angong niuhuang pill combined with Western medicine （test group） versus Western medicine alone （control group） in the treatment of ischemic stroke in acute phase were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane risk of bias tool. RESULTS： Totally 6 RCT and 3 qRCT were included， involving 620 patients. Results of Meta-analysis showed， the effective rate in test group was significantly higher than control group [OR＝4.28， 95％CI（2.62，6.98），P＜0.001]， NIHSS score was significantly lower than control group [SMD＝－0.75，95％CI（－0.95，－0.56），P＜0.001]， with statistical significances. CONCLUSIONS： Angong niuhuang pill shows good efficacy in the adjuvant treatment of ischemic stroke in acute phase， it can significantly improve the NIHSS degree.