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Objective To systematically evaluate the efficacy of Zusanli(ST36) acupoint injection of Neostigmine in the treatment of postoperative abdominal distention, and to provide evidence-based basis for the nursing and treatment of postoperative abdominal distention. Methods Randomized controlled trials (RCT) of Zusanli acupoint injection of Neostigmine for postoperative abdominal distention was searched in CNKI, Wanfang Data, VIP, PubMed and Embase. After literature screening, data extraction and quality evaluation were completed by two researchers independently, the Review Manager 5. 3 software was used for Meta analysis. Results A total of 1622 patients were enrolled in 17 RCT studies. Meta analysis showed that the total effective rate of Zusanli acupoint injection of Neostigmine was higher than that in the control group(OR= 7. 49, 95%CI[4. 66, 12. 05], P |