AIM: To assess the efficacy of ketotifen in treating allergic conjunctivitis. METHODS: A systematic search of systematic reviews and Meta-analyses was conducted on the PubMed and Web Science of Science until October 2021 to address this knowledge gap. Mean difference with 95%CI and P values were used to assess the efficacy of ketotifen. The heterogeneity (I2) was used to evaluate the impact of heterogeneity. RESULTS: Eight randomized controlled trials (RCTs) involving 1589 patients were included in this Meta-analysis. The results revealed that after treating with ketotifen, itching (MD=-0.91, 95%CI: -1.63 to -0.20, I2=94%, P=0.01), tearing (MD=-0.40, 95%CI: -0.61 to -0.18, I2=75%, P=0.0003) and total signs and symptoms (MD=-0.85, 95%CI: -1.12 to -0.58, I2=0, P<0.00001) showed better benefit effect compared to the placebo group. CONCLUSION: Topical ketotifen is an effective treatment for patients with allergic conjunctivitis.