Objective:To systematically evaluate the efficacy and safety of filiform fire needle combined with tacrolimus ointment in the treatment of vitiligo.Methods:The RCTs of combination of filiform fire needle and tacrolimus ointment on the treatment of vitiligo were searched in the Chinese Biomedical Literature Database (CBM), China Knowledge Network Full-text Database (CNKI), Wanfang Full-text Database, VIP and PubMed databases. The studies were selected with the inclusion and exclusion criteria, then data extracted, and the quality of the included studies was evaluated according to Cochrane System Evaluation Manual. Meta-analysis was performed using RevMen 5.3 software.Results:Four studies involving 218 patients were included. After analysis, it was found that the effective rate [ OR=4.42, 95% CI (1.39-14.03), P<0.05)] and the apparent efficiency [ OR=2.89, 95% CI (1.40-5.95), P=0.004] of filiform fire needle combined with tacrolimus ointment were significantly better than that of tacrolimus ointment alone. Adverse reactions werelocal slight redness, pain and itching. None of adverse reactionswas reported. Recurrence occurred in the follow-up of were reported in two studies, which found that the recurrence rate [ OR=0.17, 95% CI (0.04-0.77), P<0.05] in the combined treatment group was significantly lower than that in the control group. Conclusions:The clinical efficacy of filiform fire needle combined with tacrolimus ointment in the treatment of vitiligo is better than that of tacrolimus ointment alone, and the recurrence rate can be reduced without any adverse reactions. However, in view of the limited number, average quality and bias of the included studies, it is suggested to carry out more multi-center, large sample and high quality randomized controlled trials for further verification.