OBJECTIVES: Bevacizumab is a humanized monoclonal antibody that produces angiogenesis inhibition by inhibiting vascular endothelial growth factor A (VEGF-A). Bevacizumab was approved for combination use with standard chemotherapy for metastatic colon cancer. This research aims to conduct a systematic review on meta-analysis and cost-effectiveness analysis on standard chemotherapy plus bevacizumab for patients with metastatic colorectal cancer (mCRC) to explore the efficacy, safety and cost-effectiveness on the addition of bevacizumab. METHODS: A systematic literature search on both meta-analysis and cost-effectiveness analysis of chemotherapy plus bevacizumab on databases was carried out in several databases, such as MEDLINE, PubMed, CNKI chemotherapy. Articles were included based on specific inclusion and exclusion criteria.  RESULTS: Six included analyses indicate that chemotherapy plus bevacizumab significantly prolonged progression-free survival (PFS) and overall survival (OS). The risk of hypertension, bleeding and proteinuria are significantly increased, whereas there are no significant differences on gastric perforation, thrombosis. Eleven cost-effectiveness analysis demonstrate that the addition of bevacizumab lead to higher medical cost and healthcare cost. In most countries involved in this review, chemotherapy plus bevacizumab is not cost-effective comparing with standard chemotherapy. However, the medical and healthcare cost of using bevacizumab is lower than cetuximab. CONCLUSIONS: The addition of bevacizumab significantly increases survival benefits and slightly leads to more adverse events. Due to higher cost of bevacizumab, it is not cost-effective therapy for mCRC patients. According to the potential considerable differences on economic status, epidemiology, clinical effectiveness, the generalizability of included meta-analyses and cost-effectiveness analyses need to be taken into account. Analyses based on China local data should be processed in the future.