OBJECTIVE：To systematically evaluate the efficacy and safety of Kuanxiong aerosol in the treatment of coronary heart disease angina ，and to provide evidence-based reference for climical drug use . METHODS ：Retrieved from Cochrane Library，PubMed，Embase，CKNI，Wanfang data ，VIP，and CBM ，randomized controlled trials （RCTs）about Kuanxiong aerosol （trial group ）versus nitroglycerin （control group ）in the treatment of coronary heart disease angina were collected during the inception to Mar. 20th，2020. After literature screening and data extraction ，quality assessment was performed using the bias risk assessment tool recommended by the Cochrane System Evaluator Manual 5.1.0. Meta-analysis was performed by using Rev Man 5.3 statistical software. Sensitivity analysis was conducted for the stability of the result ，and trial sequential analysis （TSA）was performed by using TSA 0.9 software. RESULTS ：A total of 11 RCTs were included ，with a total of 1 847 cases. Meta-analysis showed that improvement rate of angina pectoris （within 3 min）[RR＝1.11，95％CI（1.02，1.22），P＝0.02] and total response rate of angina pectoris （within 5 min）[RR＝1.04，95％ CI（1.01，1.07），P＝0.01] in trial group were significantly higher than control group；the incidence of ADR [RR＝0.44，95％CI（0.35，0.57），P＜0.000 01] in trial group was significantly lower than control group. There was no statistical significance in total response rate of ECG [RR＝1.02，95％CI（0.97，1.09），P＝0.42] or the level of NO after treatment [SMD ＝－0.08，95％CI（－0.61，0.45），P＝0.76] between 2 groups. The results of sensitiv ity analysis and TSA showed that the efficacy evidence of Kuanxiong aerosol in the treatment of coronary heart disease pectoris was not accurate ，but the evidence of safety was accurate. CONCLUSIONS ：Kuanxiong aerosol can improve the efficacy in patients with coronary heart disease angina ，and the safety is better ，but the conclusions of efficacy needs to be further confirmed by enlarging sample size.