Objective To study the efficacy and safety of bone channeling in arthroscopic rotator cuff repair. Methods China National Knowledge Infrastructure, Cochrane Library, Chongqing VIP, PubMed, Wanfang database and Embase were searched to collect all randomized controlled trials of the application of bone channeling in arthroscopic rotator cuff repair. The search time was from the establishment of databases to October 15, 2025. RevMan 5.3 software was used for meta-analysis to explore the differences in postoperative functional score, pain, complications, reoperation and 2-year postoperative re-tear between the bone channeling group and the control group. Results Nine randomized controlled trial studies were finally included. The results of meta-analysis showed that there were no significant differences in the postoperative Constant Function Score [mean difference (MD)=1.27], American Shoulder and Elbow Surgeons score (MD=1.26), postoperative pain score (MD=0.27), 2-year postoperative incidence of re-tear [relative risk (RR)=1.22], reoperation rate (RR=1.19) and complication rate (RR=1.37) between the bone channeling group and the control group (P>0.05). Conclusions Existing evidence shows that the application of bone channeling in arthroscopic rotator cuff repair failed to improve the postoperative re-tear of patients, but also did not lead to pain and complications.