OBJECTIVES Tight glucose control in critically ill patients is difficult and labor intensive, resulting in poor efficacy of glycemic control and increased hypoglycemia rate. The purpose of this study was to evaluate the safety and effectiveness of the automated target glucose control using computer-based insulin algorithms compared to the conventinal glucose control using paper-based protocols. METHODS A systematic literature review and meta-analysis was used to evaluate the safety and effectiveness for the automated target glucose control. The 14 randomized control trials of 2537 articles were selected and two reviewers evaluated independently the quality of this selected articles using the Scottish Intercollegiate Guidelines Network (SIGN) tool. RESULTS The computer-based insulin protocols resulted in a shorter time to reach within target range(MD -1.03, 95%CI -1.70~-0.35, p=.003, I=77%) and a higher percentage of glucose readings within target range(MD 11.98, 95%CI 8.83~15.14, p<.001, I=89%) than the paper-based protocols. The incidence rates of above or below target range in computer-based insulin protocols were acceptable levels and the incidence rates of severe hypoglycemia below 40mg/dL in computer-based insulin protocol was significantly lower than the paper-based insulin protocols(MD -23.41, 95%CI -32.35~-14.46, p<.001, I=0%). CONCLUSIONS The automated target glucose control using computer-based algorithms resulted in tighter glycemic control without an increased risk of hypoglycemic events compared to the paper-based protocols. But taking into account the high heterogeneity between studies, these results must be interpreted with caution.