Objective To evaluate the influence and safety of topical ketamine on postoperative sore throat following endotracheal intubation. Methods The clinical literatures concerning topical application of ketamine for the prevention of postoperative sore throat (POST) were searched from online databases. Randomized controlled trials were selected by the inclusive and exclusive criteria. Meta-analysis was conducted to assess the risk ratio(RR) of the incidence of POST and software Stata 12.0 was used in this analysis. Results Seven randomized trials involving 490 patients were included in this meta-analysis. The results of meta-analysis showed that the incidence of POST was significantly reduced in the ketamine group,with RR 0.61(95%CI 0.47~0.79,P<0.001) at 0~1 h,0.55(95%CI 0.43~0.71, P<0.001) at 4 h and 0.48 (95%CI 0.34 to 0.66, P<0.001) at 24 h after surgery. No major complications related to topical ketamine were observed. Conclusions For the patients receiving general anesthesia and endotracheal intubation, topical prophylactic application of ketamine can significantly reduce the incidence of POST without major complications.