Objective:To compare therapeutic effects and safety of intracoronary (IC ) abciximab and intravenous (IV) abciximab on ST‐elevation myocardial infarction (STEMI) . Methods:The databases of PubMed ,Cochrane Central Register of Controlled Trials ,Chinese Biomedical Literature Database (CBM) and CNKI were retrieved on computers for collecting randomized controlled trials (RCTs) about comparison of therapeutic effects between IC abciximab and IV abciximab published from Jan 1993 to Jun 2014. At the same time ,the data included literature , conference abstracts and related websites were retrieved manually .The data of eligible RCTs were extracted and re‐ceived meta‐analysis using RevMan5.0 software .Results:A total of seven RCTs were enrolled .Meta‐analysis indi‐cated that incidence rate of recurrent myocardial infarction in IC abciximab group was significantly lower than that of IV abciximab group (OR= 0.61 ,95% CI:0.40~0.92 , P=0.02 );there were no significant difference in all‐cause mortality (OR=0.85 ,95% CI :0.59~1.23 ,P=0.39) ,target vessel revascularization rate (OR=0.66 ,95%CI :0.40~1.09 , P=0.10) and incidence rate of major bleeding (OR=1.00 ,95% CI :0.68~1.47 , P=0.99) be‐tween IC abciximab group and IV abciximab group . Conclusion:The IC abciximab can more significantly reduce in‐cidence rate of recurrent myocardial infarction in STEMI patients .