Background: Tongfu traditional Chinese medicine (TCM) preparation is a common alternative therapy for clinical treatment of patients with septic gastrointestinal dysfunction. In recent years, a number of randomized controlled trials (RCTs) have been conducted to verify the effectiveness of Tongfu TCM preparation in the treatment of sepsis gastrointestinal dysfunction, but all of them have been small sample studies, and the research conclusions have been controversial. Here, this study conducted a meta-analysis on the clinical efficacy of the treatment of septic gastrointestinal dysfunction with TCM preparation, to produce a more objective and comprehensive systematic review to guide clinical application. To evaluate the efficacy and safety of Tongfu traditional Chinese medicine (TCM) preparation in the treatment of patients with septic gastrointestinal dysfunction. Methods: Randomized controlled trials (RCTs) of Tongfu TCM preparation in the treatment of septic gastrointestinal dysfunction published before February 2021 were searched for in the Chinese databases (CBMdisc), and Chongqing VIP (CQVIP), and English databases PubMed, Web of Science, EBSCO, and The Cochrane Library. Meta-analysis was performed using RevMan 5.3 software, and funnel plots were drawn to evaluate the bias of literatures. Results: A total of 22 RCTs involving 1,558 patients were included. There were 772 patients in the control group and 786 in the trial group. Meta-analysis results showed that: gastrointestinal dysfunction score [mean difference (MD)=-0.50, 95% confidence interval (CI): -0.61 to -0.38], Acute Physiology and Chronic Health Evaluation II (APACHE II) score (MD=-3.30, 95% CI: -3.73 to -2.86), and mortality (MD=0.34, 95% CI: 0.25-0.47) in the experimental group were significantly lower than those in the control group, and the difference was statistically significant (P<0.001). The funnel plot results showed that there was little possibility of publication bias. Discussion: Tongfu TCM preparation can effectively improve the gastrointestinal function of patients with sepsis gastrointestinal dysfunction, prevent the deterioration of the disease, and reduce the mortality; however, more evidence is required to substantiate these findings.