Objective:To explore the safety and efficacy of eye drops without benzalkonium chloride(BAK) in treating glaucoma and ocular hypertension.Methods:The clinical case-control literatures about eye drops withoutBAK treating glaucoma and ocular hypertension were retrieved in PubMed,EMBASE,Cochrane andChineseBiological andMedical database.Meta5.0 software was used to analyze the literatures.Results:Five clinicalcontrol studies were included.The results indicated both eye drops could lower the intraocular pressure, and the intraocular pressure-lowering difference between two eye drops was0.07 mmHg(95%CI:0.04,0.19)(P>0.05).Two adverse reactions occurred more were conjunctival injection(10.78%) and allergic conjunctivitis (4.78%).The odd ratio of two eye drops occurring conjunctival injection and allergic conjunctivitis was0.67(95%CI,0.25,1.10) and0.82(95%CI,0.09,1.54), respectively(P<0.05) in fixed effect model.Conclusions:There is no difference between the eye drops with or withoutBAK in lowering intraocular pressure, but the latter is of higher safety.In consideration of the relatively small sample size of this research, more high-quality clinical research contrasts are needed as evidence.