Objective: To systematically evaluate the effectiveness and safety of integrated Chinese and Western medicine in the treatment of acute myeloid leukaemia (AML) in elderly people. Method: The Cochrane Library, PubMed, Web of Science, Excerpta Medica Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wanfang Data and VIP Data databases were systematically searched from database inception to 30 June 2023 to identify cases of AML treatment with and without integrated Chinese and Western medicine. Fixed- and random-effect models were used to pool the main results, and the pooled risk ratio (RR) with a 95 % confidence interval (CI) was used as the effect indicator. Results: Eleven randomized controlled trial (RCT) involving 828 patients were finally included. The meta-analysis results showed that the overall response efficiency of integrated Chinese and Western medicine in treating myeloid leukaemia in elderly people was better than that of Western medicine alone (RR = 1.23, 95 % CI: 1.13, 1.33, p < 0.001). There was significant difference in the complete remission rate between the two groups (RR = 1.38, 95 % CI: 1.15, 1.65, p < 0.001). The incidence of myelosuppression (RR = 0.49, 95 % CI: 0.32, 0.75, p = 0.001), hepatic and renal insufficiency (RR = 0.43, 95 % CI: 0.29, 0.66, p < 0.001), infection (RR = 0.26, 95 % CI: 0.17, 0.40, p < 0.001) and gastrointestinal discomfort (RR = 0.31, 95 % CI: 0.22, 0.46, p < 0.001) of integrated Chinese and Western medicine were significantly lower than that of Western medicine alone. Conclusion: Compared with Western medicine alone, the application of integrated traditional Chinese and Western medicine can improve the total clinical remission rate and reduce adverse effects following chemotherapy. However, more high-quality results of randomised controlled trials and analysis are needed to confirm the findings.