OBJECTIVES:  To give an overview of available evidence on cost-effectiveness of nilotinib (NL) versus imatinib (IM) for the first-line treatment of chronic myeloid leukemia (CML) as well as the quality of these studies. METHODS:  All studies were searched in 3 electronic databases (Pubmeb, Sciencedirect and Cochrane) with key words through the MeSH tool. After searching, screening identified studies with inclusion and exclusion criteria, data extraction and summary of results into pre-specified information table were undertaken. The studies were included if they were an original economic evaluation of NL versus IM in the first-line treatment of CML, written in English and conducted in the newly diagnosed patients. Abstracts of citations found that met the specified inclusion criteria were also reviewed. To compare and overview the results of studies, all currency values were transferred into $USD in 2015 based on Consumer Price Index. The report’s quality of the studies was evaluated by 3 blinded reviewers based on the Quality of Health Economic Studies (QHES) tool with 16 questions. RESULTS:  From a total 159 detected papers, 10 studies were extracted data and 3 studies were selected to evaluate the quality. Cost-effectiveness analysis, Markov model and sensitivity analysis were mostly used methods in these studies. Most researches used direct costs and used QALY as outcome. The converted ICUR/QALY of studies reached $866,436/QALY. Based on WTP threshold, 8/10 studies concluded that NL was cost-effectiveness compared with IM in the first-line of CML. Using QHES it has been shown the high quality of these studies with the mean score of 97 (1.73) on a scale of 100. CONCLUSIONS:  Most studies suggested that NL was cost-effective compared with IM in the first-line treatment of CML patients and the report’s quality of studies was very high.