OBJECTIVES: The aim of this study was to conduct a meta-analysis of randomized clinical trials (RCTs) to determine effectiveness and safety of parecoxib as an analgesic option for adult patients in orthopedics surgery. METHODS: All meta-analysis estimations were performed with RCTs based on trials with similar parecoxib doses (20 or 40 mg) and by type of comparator (placebo or other drugs). Effectiveness was assessed with patient global treatment evaluation, consuming rescue drug rate, pain intensity at 24 or 48 h after surgery and morphine consume after surgery; safety with the frequency and type of adverse events(AE). RCT were searched in December 2008 in Medline, EMBASE, International Pharmacological Abstracts and the Cochrane Collaboration. Two independent reviewers identified the abstracts, selected the full articles, and extracted the data. Odds ratios and weighted means differences were calculated. Random effects models were employed in the analyses with RevMan v.5.0 software. RESULTS: A total of 1253 studies were reviewed and 10 trials were finally selected where parecoxib was assessed in hip, knee and spine surgeries, as well as bunionectomy. In 6/10 studies, parecoxib 40mg showed a higher global treatment evaluation against placebo (OR 0.20; 95%CI 0.13–0.31) and improvements in the consuming rescue drugs rate (OR 0.18; 95%CI 0.07–0.47), as well as in cumulative morphine consumption, and pain intensity (p <0.001). In three studies, parecoxib was as effective as ketorolac, paracetamol, metamizole or morphine. Frequency of AE was similar between parecoxib and placebo or other drugs. Parecoxib 20mg showed less postoperative fever than placebo (OR 0.46; 95%CI 0.24 – 0.89). CONCLUSIONS: Parecoxib 40mg is an effective and safe analgesic option during the first hours of the postoperative period in orthopedic surgeries.