Objective To assess the efficacy and safety of Lamiophlomis rotata (Benth) Kudo in treating bleeding, pain, and inflammation of different causes. Methods Based on the principles and methods of Cochrane systematic reviews, we searched CBM (from establishment to June 2008), CNKI (1980 to June 2008), MEDLINE (1966 to June 2008), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 2, 2008)to identify randomized controlled trials (RCTs) of Lamiophlomis rotata (Benth) Kudo. We assessed the risk of bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis. Results We included 70 RCTs, of which there were 20 RCTs on bleeding, 10 RCTs on both bleeding and pain, 29 RCTs on pain, and 11 RCTs on inflammation. Most of the included studies were of low quality with a high risk of bias. ① Bleeding: We included 30 RCTs on bleeding. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of hemostasis compared with other hemostatics (OR 3.86, 95%CI 2.56 to 5.82) or the blank control group (OR 14.85, 95%CI 7.16 to 30.80). Patients in the Lamiophlomis rotata (Benth) Kudo group had less blood loss compared with other hemostatics or the blank control group and were associated with shorter duration of bleeding compared with the blank control group, but no statistical difference was noted when compared with other hemostatics. ② Pain: We included 37 RCTs on pain. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of analgesia compared with other paregorics (OR 3.01, 95%CI 2.23 to 4.06), the blank control group (OR 6.06, 95%CI 3.14 to 11.70), or placebo (OR 2.91, 95%CI 1.48 to 5.73). Patients in the Lamiophlomis rotata (Benth) Kudo group had lower pain score compared with the blank control group (MD -0.84, 95%CI -0.97 to -0.72). ③ Inflammation: We included 11 RCTs on inflammation. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of anti-inflammation compared with other antiinflammatory agents (OR 3.36, 95%CI 1.90 to 5.96). One RCT reported that Lamiophlomis rotata (Benth) Kudo could reduce joint swelling compared with other anti-inflammatory agents. ④ Safety: Twelve RCTs reported mild adverse effects in patients who received Lamiophlomis rotata (Benth) Kudo, such as mild nausea, diarrhea, and stomach discomfort, but no serious adverse effects were observed. Conclusion Current evidence demonstrates that Lamiophlomis rotata (Benth) Kudo is effective and safe in treating bleeding, pain, and inflammation. However, the results should be interpreted with caution because of the heterogeneity among the included studies and the high risk of bias. High quality RCTs with large samples are needed to further prove its effectiveness and safety.