Objective To systematically evaluate the efficacy and safety of sirolimus-eluting stents (SES) versus bare-metal stents (BMS) in treating patients with ST-segment elevation myocardial infarction. Methods The databases such as PubMed (1960 to Mar. 2011), EMbase (1980 to Mar. 2011), the Cochrane Central Register of Controlled Trials (1989 to Mar. 2011), CBM (1979 to Mar. 2011), VIP (1989 to Mar. 2011) and CNKI (1979 to Mar. 2011) were searched to collect all the randomized controlled trials (RCTs) on SES versus BMS in patients with ST-segment elevation myocardial infarction. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 4.2 software. Results A total of 7 RCTs were included. Among 2 555 patients involved, 1 282 were in the SES group, while the other 1273 were in the BMS group. The results of meta-analyses showed that SES was superior to BMS in the target-lesion revascularization (OR=0.27, 95%CI 0.16 to 0.45, Plt;0.000 01) and target-vessel revascularization (OR=0.33, 95%CI 0.24 to 0.46, Plt;0.000 01). In contrast, there were no differences between SES and BMS in death, stent thrombosis and recurrence of myocardial infarction. Conclusion With the one-year clinical outcomes, SES is more effective than BMS in reducing the rate of target-vessel revascularization and target-lesion revascularization.