Objective To systematically evaluate the effects of cognitive behavioral therapy (CBT) on improving depression, anxiety and quality of life in patients with maintenance hemodialysis (MHD). Methods We searched PubMed, EMbase, CENTRAL (Issue 8, 2016), Web of Science, CINAHL, PsycoINFO, CBM, CNKI and WanFang Data from inception to Sep. 1st, 2016, to collect randomized controlled trials (RCTs) which studied the effects of CBT on improving depression, anxiety and quality of life in patients with MHD. Literature screening, data extraction, and the risk of bias assessment of all eligible studies were conducted by two reviewers independently. Then, meta-analysis was conducted using RevMan 5.3 software. Results A total of 14 RCTs involving 1 492 patients were included. The results of meta-analysis showed that CBT could significantly improve the depression (SMD=–0.85, 95%CI –0.96 to –0.74,P<0.000 01), anxiety (SMD=–1.16, 95%CI –1.37 to –0.94,P<0.000 01), and quality of life (SMD=0.88, 95%CI 0.21 to 1.56,P=0.010) of MHD patients after 2 months' intervention; however, these effects were not been found within 2 months' intervention (allP values>0.05). Conclusion CBT is efficacious in improving MHD patients' depression, anxiety and quality of life after 2 months' intervention, while these effects within 2 months are still not certain. Because of the limitation of quantity and quality of included studies, more high-quality studies are needed to confirm the above conclusion.