Objective:To evaluate the efficacy and safety of moxifloxacin treatment on refractory,recurrent and multi-drug resistant tuberculosis. Methods:The randomized controlled trials of moxifloxacin which is used to treat the refractory,recurrent and multi-drug resistant tuberculosis were recruited. Data were analyzed using RevMan 4.2 provided by the Cochrane Center. Results:Nine RCTs were included. Meta analysis showed that compared with the control group,moxifloxacin was more effective in focus absorption[OR = 1.68,95% CI(1.14~2.49)]and sputum negative conversion[OR=2.47,95% CI(1.61~3.79)]. Adverse effect such as stomach discomfort,nausea,acid reflux,loss of appetite and other gastrointestinal reactions and mild liver dysfunction appeared,and recovered by symptomatic treatment. Conclusion:The current limited evidence suggests that the moxifloxacin treatment on refractory,recurrent and multi-drug resistant tuberculosis is useful for focus absorption and the sputum negative conversion.