OBJECTIVES: To assess the quality of systematic reviews or meta-analyses on perinatal antiretroviral therapies for preventing mother-to-child transmission of HIV. METHODS: We searched the databases of PubMed, EMBASE, CINAHL, AIDSearch, Cochrane Library (2007 issue 4), AIDS info and the Chinese Databases from the beginning of the databases to December 30, 2007. The systematic reviews (SRs) or meta-analyses of randomized controlled trials with pooled results to assess the efficacy of antiretroviral therapies for reducing MTCT of HIV were included. Two authors independently assessed the quality of the included studies by using the the Oxman and Guyatt index. RESULTS: Five systematic reviews were eligible, including 3 Cochrane reviews (Brocklehurst 2002 & 2005, and Volmink 2007) and 2 meta analyses using individual patient data (IPD Meta-analysis, Leroy 2005 and BHITSG 2004 ). The quality of the included studies were varied from 5 to 9. The included Cochrane reviews report more detailed information on the search methods used to find the evidence (Item 1), eligibility criteria for selecting studies (Item 3), criteria used for assessing the validity (Item 5), and the validity assessment appropriately (Item 6) than paper-based systematic reviews. But most of the included studies were weaker in inadequate searching strategy for the evidence (Item 2) and selection bias could not be avoided (Item 4). Only the last Cochrane Review(Volmink 2007) gains highest quality score of 9, because of its more comprehensive searching, appropriate eligibility criteria for selecting studies, and suitable methods to assess the validity and to combine the findings of the relevant studies, which seems to be helpful to reduce the bias in conducting the systematic review. CONCLUSIONS:The methodological limitations existed in most of included systematic reviews or meta-analyses, especially for searching bias, and validity assessment. The systematic reviews should be updated with emerging trials.