Objective To investigate the hearing outcome efficiency of tympanostomy tubes and when combined with adenoidectomy for otitis media with effusion treatment. Methods A systematic literature review of tympanostomy tubes and tympanostomy tubes combined with adenoidectomy were performed using PubMed, EMBASE,the Cochrane Library,MEDLINE,all of the included studies were randomized controlled trial. The quality of included studies was evaluated according to the Risk of Bias Table of the Cochrane Handbook. Data were analyzed with Review Manager 5.02 software. Heterogeneity was examined,and forest plot was drawn. Results All of the included 4 studies were randomized controlled trials. At 6 month follow-up patients,the tym-panostomy tubes and tympanostomy tubes combined with adenoidectomy had no difference in hearing improvement (WMD = 1.06,95%CI-0.18 ~ 2.29,P = 0.09). At 12 month follow-up patients,the tympanostomy tubes com-bined with adenoidectomy were better than tympanostomy tubes alone(WMD = 3.03,95%CI 0.91 ~ 5.14,P =0.005). Conclusions The meta analysis result reveals that tympanostomy tubes combined with adenoidectomy have an advantage in long term follow up time for hearing improvement in children's otitis media with effusion treatment.