Objective To systematically assess the efficacy and safety of antifibrinolytic drugs for hemostatic efficacy in cardiac surgery for cardiopulmonary diversion in children.Methods A systematic search of PubMed,Embase,and The Cochrane Library was performed to collect all randomized controlled trials(RCTs)using antifibrinolytic drugs in cardiac surgery for cardiopulmonary diversion in children from January 1st,1980 to October 14 th,2023.Meta-analysis was performed using RevMan 5.4 software.Results A total of 20 studies and 23 RCTs were included,with 9 involving peptidase,10 involving tranexamic acid,and 4 involving aminocaproic acid.The result of Meta-analysis showed that compared with the control group,all the experimental groups using antifibrinolytic drugs(peptidase,tranexamic acid,and aminocaproic acid)significantly reduced the amount of hemorrhage and transfusion in the first 24 h postoperatively(P<0.05);however,the difference of the incidence of thrombosis and death in the two groups was not statistically significant(P>0.05).Conclusion Antifibrinolytic drugs have hemostatic effects in cardiac surgery for cardiopulmonary bypass in children.Because of the paucity of evidence from relevant pediatric studies,a large number of comparative trials are needed to assess the safety associated with these drugs and the appropriate dosing regimen.