ObjectiveTo systematically review the effectiveness of appendicectomy versus antibiotics for uncomplicated acute appendicitis (UAA). MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 8, 2016), Web of Science, CBM, WanFang Data and CNKI were searched to collect randomized controlled trials (RCTs) about appendicectomy versus antibiotics for uncomplicated acute appendicitis from inception to September 2016. 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 10 RCTs studies involving 2 028 patients were included. The results of meta-analysis showed that, compared with antibiotics, the appendicectomy could shorten duration of hospital stay (MD=–1.89, 95%CI –2.75 to –1.04, P<0.000 01), the therapeutic time of antibiotics (MD=–4.42, 95%CI –5.06 to –3.79, P<0.000 01), improve the efficiency of clinical treatment (OR=23.48, 95%CI 7.99 to 68.96, P<0.000 01), decrease the recurrence rate (OR=0.02, 95%CI 0.01 to 0.05, P<0.000 01), however, there was no significant difference in the incidence of postoperative complications between two groups (OR=1.35, 95%CI 0.31 to 5.87, P=0.69). ConclusionThe current evidence shows that, compared with antibiotics, the appendicectomy for uncomplicated acute appendicitis can shorten duration of hospital stay and the therapeutic time of antibiotics, improve the efficiency of clinical treatment, decrease the recurrence rate. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.