Objective To evaluate the safety and efficacy of intermittent pneumatic compression in prevention of deep venous thrombosis after major orthopedic operation. Methods We searched MEDLINE (1966 to January 2008), The Cochrane Library (Issue 2, 2008), CBM (1996 to January 2008), CNKI (1998 to January 2008), VIP (1998 to January 2008), and retrieved clinical controlled trials (CCTs) or randomized controlled trials (RCTs) in which IPC was used as an intervention to prevent DVT, and all the trials were published in English or Chinese. The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review. RevMan 4.2 software was used for meta-analysis. Results Seven RCTs and 1 CCT were included. Their methodological quality was poor. The results of Meta–analyses showed: (1) The incidence of DVT in the IPC group was lower than that in the control group (RR=0.20, 95%CI 0.11 to 0.35, Plt;0.000 01); (2) There was no difference in the incidence of DVT between the IPC group and the LMWH group (RR=0.70, 95%CI 0.28 to 1.74, P=0.44); (3) The incidence of DVT in the IPC plus LMWH group was lower than that in the LMWH-alone group (RR=0.23, 95%CI 0.10 to 0.52, P=0.000 4). Furthermore, the incidence of DVT in the IPC plus LMWH group was lower than that in the GCS plus LMWH group (Plt;0.000 1). No severe adverse reaction of IPC in DVT prevention was reported. Conclusion IPC shows an effective tendency in DVT prevention, but because of the low quality and the small sample of the included studies, this conclusion needs to be verified by protocols of more samples and high quality.