OBJECTIVES: Undertake a meta-analysis of all randomized controlled trials (performed in China and other Countries) comparing effective and safety of ultrasonic scalpel (UAS) with conventional surgery for thyroidectomy. METHODS: A comprehensive search for published RCTs published in major medical database (PubMed, Embase, Elsevier, Wanfang and CNKI) was performed from January 2003 to November 2012; Reviews of each study were conducted and data were extracted.Outcome measures analyzed included  operation time, intraoperative blood loss, overall drainage volume, length of stay and post-operative complication rates. RESULTS: Data were retrieved from 26 RCTs(16 from China, 10 from other countries)  describing 3011 patients  In most cases conventional vessel ligation and tight were used as a conventional method. The results of the meta‑analysis demonstrated significant improvement of perioperative outcomes with the use of UAS instead of conventional surgical instrumentation. Operative time was significantly reduced from a mean of 84.6 min to 61.7(WMD: -21.66 minutes; 95% CI: -22.61, -20.71) intraoperative blood loss was decreased from a mean of 61.4 ml to 31.6 ml (WMD: -23.58 mL; 95% CI: -24.33,-22.83),length of stay was shorten from a mean of 5.8 to 4.8 days (WMD: -0.8 day; 95% CI: -0.86, -0.72) , overall drainage volume was reduced from a mean of  56.9 ml to 37.4(WMD: -21.28 mL; 95% CI: -22.15, -20.41)  in the patients underwent thyroidectomy with UAS. It also showed that the patients who were treated with UAS presented more favorable results in incidence of post-operative complications (OR: 0.54, 95% CI: 0.36, 0.81). CONCLUSIONS: Ultrasonic scalpel showed significant advantages over conventional methods in the thyroidectomy, including shortened operation time, shortened length of stay, reduced intraoperative blood loss and shortened overall drainage volume. Besides, it can also decrease the post-operative complication risks.