OBJECTIVES: Combined spinal-epidural anaesthesia (CSEA) with opioids has been widely used in labor analgesia. This study evaluates the efficacy and safety of fentanyl versus sufentanil for mothers and infants in labor analgesia with CSEA. METHODS: Computerized searches of OVID/MEDLINE, Web of science, the Cochrane Central Register of Controlled Trials, PubMed, Embase, CNKI, Wangfang Data, VIP Data, and SinoMed were conducted from inception to April 2018. Randomized controlled trials (RCTs) involving the comparisons of fentanyl versus sufentanil in labor with CSEA were included. The quality of each study was evaluated following the PRISMA guideline. The primary outcome measurement is visual analogue scale (VAS) score. The secondary outcome measurements include first-dose analgesia duration (min), analgesic effect displaying time (min), length of labor (min), blood loss (ml), Apgar score, mode of delivery and the incidence of adverse reactions. RESULTS: : A total of 3157 patients from 40 trials were included. Compared with the fentanyl group, the sufentanil group has longer first-dose analgesia duration (WMD=28.34 min, 95%CI:26.97~29.71, P＜0.00001); shorter analgesic effect displaying time (WMD= -2.23min, 95%CI:-2.34~-2.11, P＜0.00001); lower VAS scores at 5min,10min,30min,60min,90min and full cervical dilation (all P<0.01); shorter length of first, second and third stage of labor (all P＜0.0