ObjectiveTo systematically review the efficacy and safety of deproteinized calf blood extractives (DCBE) for diabetic complications. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect studies on the efficacy and safety of DCBE for diabetic complications from inception to July 8th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 69 studies were included. The results of meta-analysis showed that for diabetic neuropathy, the effect rate of DCBE was superior to control, mecobalamin, vitamin B12, vitamin B1+vitamin B12, and vitamin B2, etc. For diabetic foot, the effect rate of DCBE was superior to control, sensitive antibiotic and compound salvia-miltiorrhiza injection. For diabetic retinopathy, the effect rate of DCBE was superior to control. The incidence of adverse events associated with DCBE was 4.59%. However, there was no significant difference with the control group. ConclusionCurrent evidence shows that DCBE has good efficacy and safety in diabetic neuropathy, diabetic foot, diabetic dry eye, diabetic retinopathy, and other diseases. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.