Objective：The purpose of this study is to evaluate the efficacy and safety of PRP compared with HA by a meta-analysis.Methods：Systematic searches of all relevant studies through December. 2020 were identified from Cochrane Library, PubMed and Embase. Randomized controlled trials (RCTs) comparing clinical effectiveness of PRP and HA for KOA were included. All studies were searched and assessed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data extraction and quality assessment were conducted, and Stata 14.0 and Review manager 5.3 were used for data analysis. Results：A total of 13 studies with a total of 1259 patients were included in the meta-analysis. There were 644 patients in the PRP group and 615 patients in the HA group. After 12 months of follow-up, patients in the PRP group had lower WOMAC total score than patients in the HA group (MD = -16.57, 95% CI = -23.34 to -9.79, P = 0.000). WOMAC pain score was lower than that of HA group (SMD = -1.02, 95% CI = -1.69 ~ -0.34, P = 0.002). WOMAC function score was lower than that of HA group (SMD = -1.47, 95% CI = -2.34 ~ -0.59, P = 0.000). VAS score was lower than that of HA group (SMD = -2.75, 95% CI = -4.93 ~ -0.57, P = 0.013). There was no significant difference in the incidence of adverse events between the two groups (RR = 1.07, 95% CI = 0.80 ~ 1.42, P = 0.10).Conclusion：This meta-analysis showed that PRP was better than the HA in terms of KOA with 12 months follow-up. This suggests the PRP is a superior alternative invention for the treatment of KOA to relieve pain and recover function. PRP did not increase the probability of adverse events with HA, and there was no difference in safety between them.