Objective    To explore the effects of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patient. Methods    Using the method of systematic review of Cochrane Collaboration, we searched PubMed, Web of Science, EMbase, The Cochrane Library, CNKI and Wangfang databases, retrieving the literature from January 1970 to June 2020 to collect clinical randomized controlled trials on the effects of autologous platelet transfusion on complications and prognosis of adult cardiac surgery patients. The extracted valid data was analyzed by RevMan5.3 software. Results    Ten studies were included, with a total of 1 083 patients. The results of meta-analysis showed that there were statistical differences in the perioperative blood loss (MD=−195.15, 95%CI − 320.48-−69.83, P=0.002) and perioperative blood transfusion (MD=−0.88, 95%CI −1.23-−0.52, P<0.001). There was no statistical difference in the death rate 30 days after the operation (RR=0.90, 95%CI 0.48-1.70, P=0.75), reoperations (OR=0.48, 95%CI 0.23-1.02, P=0.06), postoperative myocardial infarction (OR=1.29, 95%CI 0.48-3.51, P=0.61), postoperative infection (OR=1.71, 95%CI 0.89-3.29, P=0.11) or postoperative ICU retention time (MD=−0.31, 95%CI − 0.67-0.05, P=0.09). Conclusion    Perioperative autologous platelet transfusion can reduce perioperative blood loss and  blood transfusion in adult cardiac surgery patients, but has no significant impact onprognosis and postoperativecomplications, which indicates that perioperative autologous platelet transfusion is a safe and beneficial blood protection measure for patients undergoing cardiac surgery.