Objective Systematically evaluate the efficacy of probiotics in treating osteoporosis.Methods Computer search of Cochrane Library,Web of Science,PubMed,Embase,VIP,CNT and Wanfang data knowledge service platform,the search time limit of August 15,2023,included as a randomized controlled experiment of probiotics for the treatment of osteoporosis.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included literature.The effects of probiotic treatment on BMD,blood calcium,vitamin D,parathyroid hormone,osteocalcin,bone alkaline phosphatase and adverse reactions were analyzed by using Stata A.14 and Revman.5.4 software.Results Eight articles were finally included,Including 744 study subjects,The results of the Meta-analysis showed that,Add probiotics to traditional drug therapy,Can increase hip bone mineral density in patients[WMD 0.05(0.01,0.10)]g/cm3,Increase the calcium ion concentration in the patient's blood[WMD 0.26(0.02,0.50)]mmol/L mmol/L,Increase the concentration of blood osteocalcin[WMD 1.84(0.60,3.07)]ng/mL,Lower the bone-specific alkaline phosphatase concentration[SMD-1.06(-2.06,-0.07)],And reduce the incidence of nausea and diarrhea,However,there was no significant change in vitamin D and parathyroid hormone.Conclusion The addition of probiotics on the basis of routine treatment may improve the level of bone mineral density and reduce the adverse reactions of gastrointestinal tract,which is beneficial to the prognosis of patients.