OBJECTIVE： To systematically review the effectiveness and safety of combination prescription of lidocaine with ropivacaine for anesthesia， and provide evidence-based reference for developing new compound preparation. METHODS： Retrieved from CJFD， Wanfang Database， VIP， PubMed and EBSCO， randomized controlled trials （RCT） about lidocaine combined with ropivacaine versus lidocaine alone or ropivacaine alone for anesthesia were collected. Meta-analysis was performed by using Rev Man 5.0 software provided by the Cochrane Collaboration after data extracting and quality evaluating. RESULTS： Totally 30 RCT were included， involving 2 442 patients. Results of Meta-analysis showed， lidocaine+ropivacaine vs. lidocaine： onset time was 6.77 min vs. 7.11 min [MD＝－0.29， 95％CI（－0.43，－0.16），P＜0.001]， maintenance time was 5.11 h vs. 2.11 h [MD＝3.13， 95％CI（3.02， 3.25），P＜0.001] and the incidence of adverse reactions was 28.6％ vs. 44.6％ [MD＝0.43， 95％CI（0.31， 0.62），P＜0.001]； lidocaine+ropivacaine vs. ropivacaine： onset time was 9.49 min vs. 15.85 min [MD＝－4.43，95％CI（－4.63，－4.22），P＜0.001]； maintenance time was 4.84 h vs. 6.79 h [MD＝－0.61，95％CI（－0.71，－0.51），P＜0.001]； the incidence of adverse reactions was 44.8％ vs. 48.1％ [MD＝0.82， 95％CI（0.56，1.19），P＝0.30]. Sensitivity analysis showed that the results were in stability. CONCLUSIONS： Lidocaine combined with ropivacaine shows rapid onset and long duration in anesthesia， and it can reduce adverse reactions play their respective advantages.