OBJECTIVES:: To evaluate the safety and efficacy of medical treatments used in acromegaly. METHODS:: A systematic search was conducted in the electronic databases PubMed, Scopus, Web of Science, and Scielo. Head-to-head or against placebo randomized controlled trials (RCT) in acromegaly patients were included. Data regarding baseline characteristics, the outcomes insulin-like growth factor 1 (IGF-1) and/or growth hormone (GH) control and adverse events were extracted. The meta-analyses were performed using the software Addis 1.16.8. RESULTS::