AIM: To perform a Meta-analysis on the precision and safety of femtosecond laser (FSL) capsulotomy compared with manual continuous curvilinear capsulotomy (CCC). METHODS: We searched PubMed, EMBASE, Web of Science, the Cochrane Library databases, and Clinical Trials.gov that maintained our inclusion criteria. Reference lists of retrieved articles were also reviewed. The effects of morphology of capsulorhexis and the tears of anterior capsule were calculated by using random-effect models. RESULTS: We identified 4 randomized and 7 nonrandomized studies involving 2941 eyes. The diameter of capsulotomy and the rates of anterior capsule tear showed no statistically difference between FSL group and manual group (MD=0.03; 95%CI, -0.03 to 0.09, P=0.31), and (OR=1.40; 95%CI, 0.28 to 6.97, P=0.68) respectively. In terms of the circularity of capsulotomy, FSL group had a more significant advantage than the manual CCC group (MD=0.09; 95%CI, 0.05 to 0.12, P<0.0001). CONCLUSION: Our Meta-analysis shows that FSL can perform a capsulotomy with more precision and higher reliability than manual CCC. The results in diameter of capsulotomy and the rate of anterior capsule tears was no significant difference between FSL and manual CCC groups. However in terms of circularity, the FSL was superior to the manual procedure.