Objective:To compare clinical efficacy and safety between intravenous glucocorticoid (IVGC) pulse therapy and oral route in the management of Graves’ ophthalmopathy. Methods:All randomized controlled trials (RCTs) comparing IVGC with oral route for the management of Graves’ ophthalmopathy were identified by manual and computer retrieval. All related data were extracted. Meta analysis was conducted using the statistical software RevMan 5.2 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration. Results:Fifty-four papers were found and 5 RCTs involving 256 patients (134 patients in the IVGC group and 131 patients in the oral route group) were included. The meta analysis showed that the IVGC group was associated with significant improvement of clinical activity score (CAS) compared with the oral route group (WMD = 0.82,95%CI:0.61~1.03,P < 0.001),proptosis (WMD = 0.62,95%CI:0.11~1.12,P = 0.02),lid width (WMD = 0.72,95%CI:0.14~1.30,P = 0.01),but the reduction of diplopia showed no difference between the two groups (OR = 1.51,95%CI:0.77~2.95,P = 0.23). IVGC had lower incidence of side effects than the oral route (OR=0.16,95%CI:0.08~0.30,P < 0.001). Conclusion:Compared with the oral route,IVGC pulse therapy showed better efficacy and safety in the management of Graves’ ophthalmopathy.