OBJECTIVES: Lung cancer is the cancer ranking top one in both incidence and mortality among cancers in China. More than 85% of lung cancer patients suffer from non-small cell lung cancer (NSCLC). As the first epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor marketed in China, gefitinib was recommended as first and second line therapy for advanced NSCLC patients with EGFR mutation by China guideline for treatment of primary lung cancer. This study aims to systematically evaluate cost-effectiveness of geftinib in China. METHODS: A systematic review of cost-effectiveness of geftinib in China was conducted. We searched for Chinese literatures in “CNKI”, “Wanfang data”, and “VIP.com”. Search pattern was “gefitinb” AND “cost or economic or expense” in abstract. Publication deadline was Mayth, 201 Cost analysis (CA), cost-effectiveness analysis (CEA), cost-utility analysis (CUA), and cost-benefit analysis of gefitinib were included. NoteExpress 2.7 was used for literature management.  RESULTS: We retrieved abstracts of 39, 42 and 20 from CNKI, Wanfang and VIP respectively. Then 59 abstracts were selected to conduct abstract analysis after deleting duplications, followed by 15 selected to full-text analysis. At last, 7 studies were included. For first line treatment comparison, 1 CUA evaluating gefitinib and chemotherapy (paclitaxel+carboplatin) shows geftinib dominates the chemotherapy with an ICER of ￥-13499.7/QALY. For second line comparison, 2 CAs show costs of geftinib are much lower than comparators, 3 CEAs show gefitinib is cost effective compared to erlotinib with much lower cost-effectiveness ratios, and 1 CEA shows docetaxel is dominated by gefitinib, which has much lower costs(￥23022 vs. ￥24390) and higher objective response rate(26.90% vs. 10.30%). CONCLUSIONS: Our systematic review demonstrates that Gefitinib is cost effective in both first and second line treatment of NSCLC in a Chinese setting.