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Background: The aim of this study is to compare the efficacy and safety of ertapenem with ceftriaxone based therapy, which has been demonstrated to be highly effective for the complicated infections. Methods: We searched PubMed, EMBASE, and the Cochrane Library for published randomized controlled trials that compared the efficacy and safety of ertapenem with ceftriaxone based therapy for the treatment of complicated infections including CAP, cUTIs, and cIAIs. Meta-analysis was performed by RevMan 5.0.Result: 8 RCTs, involving 2883 patients, were included in our meta-analysis. Ertapenem was associated similar clinical treatment success with ceftriaxone based therapy for complicated infections (1326 patients, FEM, OR: 1.13, 95CI％:0.75-1.71). There was no difference between the compared treatment groups regarding microbiological success. And no difference was found regarding the incidence of clinical and laboratory drug-related adverse events between ertapenem and ceftriaxone groups. As to local tolerability, overall, there was no difference between the compared groups, however, in the subgroup analysis, local reaction was significantly less in ertapenem subgroup than ceftriaxone plus ceftriaxone subgroup. Conclusion: This meta-analysis provides evidence that ertapenem can be used as effectively and safely as ceftriaxone, for the treatment of complicated infections. It is an appealing option for the treatment of these complicated infections.