Abstract: Objective To evaluate the efficacy and safety of Chaihu Shugan Powder in the treatment of Hashimoto’s thyroiditis. Methods Randomized controlled trials of Chaihu Shugan Powder in the treatment of Hashimoto’s thyroiditis were searched from China Knowledge Network, VIP Database, Wanfang Database, China Biomedical Literature Database, PubMed, Embase and Cochrane Library from date of database inception until October, 2024. Meta-analysis was performed using RevMan 5.3. Results A total of 9 literatures were included, involving 671 patients with Hashimoto’s thyroiditis. Meta-analysis showed that Chaihu Shugan Powder could improve the clinical effectiveness rate of Hashimoto’s thyroiditis RR （95%CI） =1.21 （1.13, 1.30）, reduce the levels of thyroid peroxidase antibody TPO-Ab, SMD （95%CI） =-1.61 （-2.28, -0.94）, decrease the level of thyroglobulin antibody TgAb, SMD （95%CI） =-1.28 （-1.70, -0.86）, reduce traditional Chinese medicine syndrome score MD （95%CI） =-6.15 （-6.69, -5.61）, improve function of thyroid TSH： MD （95%CI） =-0.83 （-1.57, -0.09）, FT₃： MD （95%CI） =0.64 （0.12, 1.16）, FT₄： MD （95%CI） =2.31 （0.70, 3.92） and reduce the level of inflammatory factor interleukin-23 IL-23, SMD （95%CI） =-1.92 （-2.29, -1.54）. In addition, compared with the control group, Chaihu Shugan Powder did not increase the incidence of adverse reactions. Conclusion Chaihu Shugan Powder is an effective and safe treatment for Hashimoto’s thyroiditis, but further research and verification is needed.