Background: Lingguizhugan decoction is commonly used to treat metabolic syndrome; however, its curative effect on hypertension is still unclear. Our study aimed to evaluate the clinical efficacy and safety of Lingguizhugan decoction combined with western medicine in the treatment of hypertension. Methods: We searched 7 electronic databases for relevant studies and full-text articles involved in the evaluation of clinical effects difference between Lingguizhugan decoction combined with western medicine and western medicine alone. All included articles were quality assessed and data analysis was conducted with Review Manager (5.4). Sensitivity analysis was performed, and the results were visualized by means of forest and funnel plots. Results were expressed as risk ratio (RR) or mean difference (MD), together with their 95% confidence intervals (CIs). Results: In total, 7 studies eventually met our inclusion criteria. The results showed that Lingguizhugan decoction combined with western medicine had a better improvement in decrease systolic blood pressure (SBP) (MD =12.33 mmHg; 95% CI: 3.37 to 21.28; P=0.007) and diastolic blood pressure ( DBP) (MD =7.42 mmHg; 95% CI: 1.89 to 12.95; P=0.009) than western medicine alone, it also had a higher effective ratio (RR =1.20; 95% CI: 1.11 to 1.31; P<0.0001) and lower adverse reactions (RR =0.51; 95% CI: 0.30 to 0.86; P=0.01). The results were robust and no obvious publication bias was observed in this study. Discussion: Our research supported that Lingguizhugan decoction combined with western medicine can effectively reduce patients' blood pressure and improve their clinical symptoms. Because of the limitation in the quantity and quality of the included studies, further large sample and multi center follow-up controlled trials should be carried out to validate our conclusions.