Objective To systematically review the efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies.Methods PubMed, Web of science, The Cochrane Library, EMbase, CNKI and Wanfang were searched by computer for relevant literatures on CAP-assisted endoscopic treatment of esophageal foreign bodies from establishment to November 2022. Data were processed using RevMan 5.4.1. Results Finally, 27 studies were included, including 17 randomized controlled trials, 2 Cohort studies and 8 case-control studies, with a total of 3 619 patients. Meta-analysis results showed that compared with traditional endoscopic treatment, the success rate of removal of esophageal foreign bodies in CAP-assisted endoscopy group was higher (OR=14.43, 95%CI 10.64 to 19.55, P<0.000 01), postoperative complications were fewer (OR=0.30,95%CI 0.23 to 0.38, P<0.000 01), patients had better tolerance (OR=4.07, 95%CI 2.95 to 5.60, P<0.000 01), intraoperative visual field clarity was better (OR=12.00, 95%CI 7.29 to 19.76, P<0.000 01) and operative time was shorter (SMD=−1.83, 95%CI −2.31 to −1.34, P<0.000 01). Conclusion CAP-assisted endoscopic treatment of esophageal foreign bodies is an effective and safe method, worthy of further promotion and application in clinical practice.