OBJECTIVE:To compare the clinical effect of repair and meniscectomy in the treatment of posterior root tear of medial meniscus of knee joint. METHODS: A computer-based search was conducted on PubMed, Cochrane Library, web of science, CNKI, Wanfang database and VIP database for clinical research literature on the comparison between repair of posterior root tear of medial meniscus and partial resection from the establishment of the database to October 2020. Two researchers screened, extracted and evaluated the quality of the retrieved literature according to the inclusion and exclusion criteria set in this study. The Review Manager 5.4 software was used according to the international knee scoring Committee (IKDC), Lysholm knee score, Kellgren-Lawrence grade, medial meniscus joint space, and whether it is necessary to undergo total knee arthroplasty for meta analysis. RESULTS: A total of 263 patients were included in the 6 studies, including 149 patients treated with repair and 114 patients treated with meniscectomy.Results: Lysholm score (MD=9.72, 95%CI: 3.27-16.16, P=0.003), IKDC score (MD=11.91, 95%CI: 1.21-22.61, P=0.03), Kellgren-Lawrence grade (OR=0.09, 95%CI: 0.04-0.21, P < 0.000 01), undergo total knee arthroplasty (OR=0.10, 95%CI:0.04-0.24, P < 0.000 01), the repair group was superior to the meniscectomy group.The medial meniscus joint space (MD=1.28, 95%CI: 0.00-2.55, P=0.05) was significantly marginal. CONCLUSION:Compared with the meniscectomy, the repair was better in clinical score and long-term prognosis than the medial meniscus resection.The meniscectomy group also showed remission of symptoms in some cases.Regardless of the treatment option, patient selection is critical to achieving a satisfactory clinical outcome.