Objective:To evaluate the effectiveness and safety of acupuncture combined drug anesthesia and simple drug anesthesia in anorectal surgery.Methods: The randomized controlled trials of acupuncture combined with drug anesthesia was evaluated using Cochrane systematic review method. The search scope was China National Knowledge Intet, wanfang database, China Biomedical Literature, Pubmed and Embase. The deadline was December 31, 2018. The randomized controlled trials of acupuncture combined with anesthesia that met the inclusion criteria were selected. In terms of trial quality evaluation, Cochrane risk bias was used for evaluation. Finally, RevMan 5.2 software was used for statistical analysis.Results: This study finally included 15 articles, a total of 1321 patients. The heterogeneity of significant rate was good, and the combined effect amount OR was 3.55 (95％ CI [2.06,6.12]). The combined effect quantitative test (Z = 4.57,P <0.00001) showed that there was a statistical significance, indicating that acupuncture combined drug anesthesia was better than simple anesthesia in anorectal surgery. The heterogeneity of adverse reactions was good, and the combined effect test (Z = 8.88,P <0.00001) showed that there was a statistical significance, indicating that the adverse reaction rate of acupuncture combined with drug anesthesia was lower than that of simple drug anesthesia in the anorectal surgery.Conclusion:Compared with simple drug anesthesia, acupuncture combined with drug anesthesia can improve the anesthesia effect and reduce the occurrence of adverse reactions in anorectal surgery.