Objective: To evaluate the clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver. Methods: Randomized controlled studies were searched in Chinese and English databases from March 30, 2020. The quality was evaluated after literature screening and statistical analysis by RevMan5.3 software. Results: Nine studies were included, involving 780 patients. Meta analysis showed that berberine alone or in combination could reduce total cholesterol (MD=-0.50,95％CI), low density lipoprotein (MD=-0.34,95％CI) and glutamyltransferase (MD=-20.79,95CI％). Subgroup analysis showed that berberine combined with berberine could reduce glycosylated hemoglobin level [MD=-0.68,95％CI (- 0.98 maxim 0.38)], while in patients with diabetes treated with berberine, alanine aminotransferase (MD=-9.38,95CI％) and aspartate oxaloacetic transaminase (MD=-9.03,95CI％) decreased significantly. The above differences were statistically significant (P 0.05). Conclusion: Berberine can regulate glucose and lipid metabolism in patients with non-alcoholic fatty liver and has a tendency to improve liver function and insulin resistance.