To evaluate the clinical efficacy and safety of moxibustion and western medicine in the treatment of chronic atrophic gastritis (CAG).Methods:Clinical randomized controlled trials (RCTs) on the comparison of moxibustion and western medicine in treating CAG were retrieved from the databases including PubMed，Cochrane Library，Embase，Web of Science，CNKI，CCD，CSPD，and CBM from database inception to October 31st，2021.The research papers were screened out and data were extracted according to the set inclusion and exclusion criteria.The Cochrane risk-of-bias tool was used to evaluate the quality of included papers，and the RevMan 5.4.1 was used for data analysis.Results:Thirteen RCTs were included，involving 1 062 patients with CAG，but the overall quality of the included RCTs was not high.As revealed by Meta-analysis results，the clinical effective rate of moxibustion in the treatment of CAG was higher than that of western medicine.In terms of improving clinical symptoms，moxibustion was superior to western medicine in alleviating epigastric burning pain，epigastric fullness，and epigastric stuffiness of CAG patients.In terms of improving gastrointestinal protein，moxibustion was superior to western medicine in improving PG I/PG II and G-17 levels.However，there was no significant difference between moxibustion and western medicine in improving gastroscopic efficiency，and gastroscopic and pathological scores of the gastric mucosa.Conclusion:The efficacy of moxibustion in the treatment of CAG is better than that of western medicine.However，due to the limitations of the quality and quantity of the included RCTs，more high-quality studies are needed to verify the efficacy of moxibustion in the treatment of CAG.