Objective Evaluate the efficacy and safety of telbivudine during the second and third trimester of pregnancy in intrauterine transmission of hepatitis B virus.Methods A database was constructed published in English and Chinese from November 2006 to February 2013.One RCT and six CCSs were included.Results The intrauterine transmission rate in the control group was 8.25-42.31％ indicated by HBsAg seropositivity of infants at 6-12 months postpartum.This rate was reduced to 0-14.29％ in the telbivudine treatment group (OR 0.33, P ＜ 0.001).The intrauterine transmission rates based on HBV DNA seropositivity of infants at 6-12 months postpartum were 8.25-19.23％ in the control group and 0-3.57％ in the treatment group (OR 0.07, P ＜0.001).With the exception of CK elevations, adverse effect frequencies were similar in both groups.Conclusion Telbivudine is an effective and safe drug for preventing intrauterine transmission of HBV.