This study aims to systematically evaluate the clinical efficacy and safety of Buyang Huanwu Decoction in the treatment of vascular cognitive impairment(VCI) through Meta-analysis.Methods:Randomized controlled trials(RCTs) on the treatment of VCI with Buyang Huanwu Decoction were searched from China National Knowledge Infrastructure(CNKI)，Wanfang Data，VIP，and PubMed(from establishment of the database to May 20，2020).Then two researchers independently completed literature screening，data collection，result checking，and methodological bias risk assessment according to the inclusion and exclusion criteria.In case of any disagreement，the two discussed or sought for opinions of a third researcher.RevMan 5.3 was employed for Meta-analysis.Results:A total of 14 eligible articles were screened out，involving 1 151 patients.In these trials，the treatment group was given Buyang Huanwu Decoction alone or in combination with western medicine.The control group received western medicine or the blank control was designed.The following conclusions were drawn from these trials. 1)The clinical effective rate in the treatment group was higher than that in the control group within the 1-month，2-month，or>3-month course. 2)Buyang Huanwu Decoction alone or in combination with western medicine can better improve the MMSE score than western medicine alone. 3)Buyang Huanwu Decoction alone or the combination with nootropic western medicine was superior to western medicine alone in the improvement of ADL score and the effect of the decoction combined with western medicine for improving brain blood supply was equivalent to that of western medicine alone.Four studies reported on adverse events，none of which occurred.Thus，the prescription is safe and can be used in clinical settings.Conclusion:Buyang Huanwu Decoction is effective and safe in the treatment of VCI.However，in view of the small quality of the included articles，high-quality clinical trials are still needed for further support.