OBJECTIVE：To systematically review the efficacy and safety of misoprostol combined with 10％ Calcium gluconate injection in the treatment of postpartum hemorrhage， and provide evidence-based reference for the clinical treatment. METHODS： Retrieved from PubMed， EMBase， Ovid， CBM， CJFD and VIP， randomized controlled trials （RCT） about misoprostol combined with 10％ Calcium gluconate injection （test group） versus conventional oxytocin in the treatment of postpartum hemorrhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Cochrane systematic review manual 5.1.0. RESULTS： Totally 7 RCTs were enrolled， involving 1 254 pregnant women. Results of Meta-analysis showed， compared with conventional oxytocin， misoprostol combined with 10％ Calcium gluconate injection can significantly reduce 2 h postpartum hemorrhage [MD＝－76.76， 95％CI（－105.73，－47.79），P＜0.001]， 24 h postpartum hemorrhage [MD＝－118.28，95％CI（－167.78，－68.78），P＜0.001] and the incidence of postpartum hemorrhage [OR＝0.19， 95％CI（0.08， 0.46），P＜0.001]， and shorten the 3rd delivery process [MD＝－3.52， 95％CI（－4.20，－2.84），P＜0.001]， the differences were statistically significant； there was no significant difference in the intraoperative hemorrhage [MD＝－61.31，95％CI（－121.98，－0.64），P＝0.05] and neonatal 1 min Apgar score [MD＝0.10，95％CI（－0.38，0.59），P＝0.67] in 2 groups. The incidences of chest distress， breathlessness and stomach discomfort in test group were significantly higher than control group [OR＝18，95％CI（2.42，133.98），P＝0.005]， but it was mild， and there was no significant difference in the incidence of fver， chills and nausea， vomiting， diarrhea and other adverse reactions. CONCLUSIONS： Both the efficacy and safety of misoprostol combined with 10％ Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies， more large-scale and long-term follow-up studies with strict designed are required for further validation of the conclusions.