To systematically evaluate the safety of integrated traditional Chinese and western medicine in the treatment of myasthenia gravis(MG) and explore the prescription selection and medication regularity.Methods:Databases，such as CNKI，Wanfang Data，VIP，PubMed，and Cochrane Library were searched for clinical randomized controlled trials(RCTs) on the application of integrated traditional Chinese and western medicine in the treatment of MG.Two researchers independently screened the research articles and evaluated the quality using Revman 5.4 according to the inclusion and exclusion criteria.Results:Twelve RCTs were enrolled，involving 1 048 cases.The Meta-analysis results showed that the integrated traditional Chinese and western medicine group was superior to the control group in terms of clinical absolute score(MD=2.75，95%CI 1.49 to 4.02，P<0.000 1)，TCM syndrome score(MD=2.21，95%CI 1.15 to 3.27，P<0.000 1)，total clinical effective rate，and safety evaluation(all P<0.05).The selected prescriptions in 12 RCTs were discussed.One repeated prescription was excluded，and 11 prescriptions were included.Forty-five Chinese herbal drugs were involved with a total frequency of 108 times，which were dominated by qi-tonifying，yang-tonifying，and yin-tonifying drugs，and the majority of the drugs acted on the liver，spleen，and stomach meridians.High-frequency drugs included Astragali Radix，Citri Reticulatae Pericarpium，Angelicae Sinensis Radix，and Atractylodis Macrocephalae Rhizoma.Conclusion:Compared with the control group，the integrated traditional Chinese and western medicine is safe and effective in the treatment of MG，with few adverse reactions.However，due to the moderate quality of the included RCTs，the efficacy and safety still need to be further confirmed by more rigorously designed high-quality RCTs.