Objective To evaluate the efficacy and safety of prostaglandin E1 (PGE1) for diabetic peripheral neuropathy (DPN). Methods We searched the Cochrane Library, PubMed, EMbase, CNKI, VIP and handsearched Chinese Journal of Metabolism, Chinese Journal of Diabetes and New Chinese Medicine. Randomized controlled trials of clinical therapeutic studies on PGE1 for DPN were included. The quality of included studies was evaluated and Meta-analysis was performed. Results Thirty-one trials involving 2 497 participants were included. Meta-analysis indicated that PGE1 was more effective than Vitamin B, Placebo and other microcirculation improving drugs in improving symptoms and signs of DPN. The RR (95%CI) were ［RR=1.75, 95％CI (1.54, 2.00)］, ［RRpooled=1.57, 95％CI (1.42, 1.74)］and［RR=1.31, 95％CI (1.19, 1.45)］respectively. PGE1 was more effective than Vitamin B, Placebo and other microcirculation improving drugs in improving nerve conduction velocity (NCV) of DPN patients. For spontaneous pain and hypesthesia of DPN patients, Lipo-PGE1 was more effective compared with PGE1-CD and the RR (95%CI) was［RR=1.43, 95％CI (1.16, 1.76)］. Slight adverse effects were reported in 16 studies. Conclusion Based on this review, PGE1 is effective for DPN. However, the evidence is not b enough due to the low quality of included trials. Further large-sample and multi-center studies are needed.