Background; Biological agents have become an important treatment for moderate-to-severe ulcerative colitis (UC). Studies have shown that vedolizumab (VDZ) has good efficacy. Ainis; To systematically evaluate the efficacy and safety of VDZ in the treatment of moderate-to-severe UC. Methods; Studies on VDZ, anti-tumor necrosis factor (TNF)-α in treatment of moderate-to-severe UC were retrieved from PubMed, Web of Science, EBSCO, The Cochrane Library, CNKI, SinoMed from the date of database establishment to August 2021. According to inclusion and exclusion criteria, literatures were screened and extracted. RevMan 5. 4 software was used to conducted meta-analysis. Results; Eleven studies involving 3 921 patients were included. Meta-analysis showed that the clinical response rate ( OR = 2. 14, 95% CI; 1. 73-2. 64, P<0.00001), the clinical remission rate (OR = 1.67, 95% CI; 1.42-1.96, P<0.00001), the endoscopic response rate (OR = 1.62, 95% CI; 1.29-2.03, P<0.000 1), and the histological response rate (OR = 1. 98, 95% CI; 1.61-2.44, P<0.000 01) in VDZ group were significantly higher than those in anti-TNF-α group. However, no significant difference in incidence of adverse reactions was found between the two groups (OR = 0.51, 95% CI; 0.26-1. 01, P = 0.05). Conclusions; Compared with anti-TNF-α, VDZ is more effective in the treatment of moderate-to-severe UC, and there is no significant difference in incidence of adverse reactions.