Abstract: Objective Our study aimed to evaluate the efficacy and safety of roxadustat for the treatment of renal anemia in patients with chronic kidney disease (CKD) by meta-analysis. Methods PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Database, Wanfang Data, VIP database were retrieved for those studies on roxadustat for the treatment of renal anemia by Mar. 2019 through computer. Studies screening and data extraction were performed by two independent investigators, and literature quality was evaluated. The enrolled randomized controlled trails were done for meta-analysis with RevMan 5.3 software. Results A total of 4 randomized controlled trials were included in the Meta-analysis. The Meta analysis showed that roxadustat obviously increased blood Hb and total iron-binding capacity (TIBC) level among anemia patients with chronic kidney disease who were not dialysis-dependent (NDD). For NDD patients, it reduced ferritin levels and had no significant effect on hepcidin levels. In anemia hemodialysis patients with CKD, roxadustat achieved anemia correction with increased serum Hb levels, and had no significant effect on TIBC, ferritin and hepcidin levels. Adverse events of roxdustat for treatment of anemia in NDD patients were similar to those of placebo in the NDD study. Conclusions Roxadustat can significantly improve the anemia in CKD patients, with no significant difference of its short-term safety compared with placebo.