Background: Proprotein convertase subtilisin / Kexin type 9 (PCSK9) inhibitors are efficacious lipid-lowering agents. This drug is related to improving the prognosis of patients with cardiovascular disease (CVD). The pur-pose of this meta-analysis was to systematically analyze the safety and efficacy of PCSK9 inhibitors in all pub-lished randomized controlled trials (RCTs). Methods: As of October 25, 2021, we searched PubMed, EMBASE, MEDLINE, Cochrane Library and web of science. Results: From 684 articles, we included 11 trials for meta-analysis, including 52511 participants (26938 in the PCSK9 inhibitor group and 25573 in the control group). In terms of effectiveness, PCSK9 inhibitors reduced the risk of major adverse cardiovascular events(MACE) (OR=0. 89, 95% Cl: 0. 83-0. 95, P=0. 0009), but did not significantly reduce the risk of cardiovascular death (OR=0. 95, 95% Cl: 0. 84-1. 07, P=0. 38) or all-cause death (OR=0. 93, 95% Cl: 0. 85-1. 03, P=0. 18),In terms of safety, PCSK9 did not increase the risk of treatment-emergent adverse events (TEAE)(OR=0. 98, 95% Cl: 0. 94-1. 02, P=0. 28). Conclusion: PCSK9 inhibitors can significantly reduce the risk of MACE in patients with high cardiovascular risk, which is well tolerated, but the impact on the risk of death is unclear.