Objective To evaluate the topical hemostatic efficacy and safety of fibrin sealant (FS) in primary total hip arthroplasty (THA) through a meta-analysis.Methods All randomized controlled trials about evaluating the efficacy and safety of topical administration of FS during THA were searched on the database of Cochrane Library,Medline,Embase,PubMed,Ovid,CBM,VIP,Wanfang data and CNKI.Methodological quality assessment of the included literatures was performed using the Cochrane risk evaluation tool.Software Revman 5.30 was used for the meta-analysis.Results A total of seven literatures involving 473 patients were identified.There were 229 patients in FS group and 244 patients in control group.Compared to control group,topical use of FS was effective to reduce total blood loss (WMD =-131.89,95 ％ CI-258.11--5.66,P ＜ 0.05),transfusion rate (RD =-0.06,95 ％ CI-0.17-0.05,P ＞ 0.05),tube blood loss (WMD =-93.44,95 ％ CI-171.58--15.29,P ＜ 0.05),drain volume (WMD =-32.59,95％ CI-64.19--0.99,P ＜0.05) and reduced level of hemoglobin (Hb) (SMD =-0.31,95％ CI-0.53--0.09,P ＜ 0.05).Incidence of deep vein thrombosis (DVT) and infection did not differ significantly between the two groups (P ＞ 0.05).Conclusion Topical use of FS can effectively reduce blood loss and transfusion rate after THA,but the rate of embolism events and infection not increased correspondingly.