OBJECTIVES: To assess comparative effectiveness of robot-assisted radical prostatectomy(RARP) versus radical prostatectomy(RP) in patients with localized prostate cancer. METHODS: We performed a systematic review using existing systematic reviews to investigate clinical effectiveness and safety of RARP. Electronic databases were searched from 1948 to July 2013, including ovidMEDLINE, ovidEMBASE, Cochrane Library, Koreamed, Kmbase, etc. We assessed the relevance and quality of selected systematic reviews related to the research question through the revised assessment of multiple systematic reviews(R-Amstar). We also searched additional studies regarding RARP after 2010. Two independent reviewers extracted data and assessed the quality using revised Cochrane Risk of Bias tool(ROB). Meta-analysis was carried out by Revman 5.2 and Comprehensive meta analysis 2.0(CMA). Cochrane-Q-statistic and I2-statistic were used to assess heterogeneity. RESULTS: We selected two existing systematic reviews of RARP in patients with prostate cancer as best available evidence and found 23 additional studies from new search after the latest search that was done by existing SRs. Finally, we evaluated 52 articles. All study was non-randomized comparative studies. RARP when compared with open surgery is associated with reduction incidence of complication (bladder neck contracture, organ injury, pulmonary embolism etc.), peri-operative outcome and the length of hospital stay. The risk of functional outcome was higher in RARP compared RP. However, oncological outcome was not statistically significant. CONCLUSIONS: This study presented that RARP is superior in terms of safety, peri-operative outcome, and functional outcome compare the RP. However Most of included studies have a low quality and there was high degree of heterogeneity. Therefore, the result of this study should be accepted carefully.