Objective To assess the clinical effectiveness and safety of astragalus injection plus androgen versus androgen alone for patients with aplastic anemia (AA). Methods Such databases as The Cochrane Library (Issue 3, 2011), PubMed (1966 to March 2011), EMbase (1974 to March 2011), CNKI (1994 to March 2011), VIP (1989 to March 2011) and Wanfang Data (1997 to March 2011) were searched to include the randomized controlled trails (RCTs) according to the inclusive and exclusive criteria. The data were extracted, the quality was assessed, and meta-analysis was conducted by using Revman5.0.24 software. Results Seven RCTs involving 518 patients with AA were included. The meta-analysis showed that the astragalus plus androgen treatment group was superior to the androgen alone group in the total effective rate with significant difference (OR=3.12, 95%CI 2.09 to 4.66, Plt;0.000 01); the adverse events in the treatment group were fewer than those in the control group with significant difference (OR=0.30, 95%CI 0.12 to 0.76, P=0.01); but the promotion degree of myelosis between the two groups was similar without significant difference (OR=1.93, 95%CI 0.85 to 4.38, P=0.11). Conclusion The astragalus plus androgen treatment is superior to the androgen alone treatment in the total effective rate and fewer adverse events. More high-quality trails are required to verify this conclusion due to the low quality and small scale of the included studies.