Objective:To discuss the efficacy of hydrocortisone for treating hypotension and reduction of vasopressor requirements in preterm infants. Methods:A search in Cochrane Library,PubMed,Ovid,Springer was performed to identify relevant articles according to the inclusion criteria. Standard meta-analytic techniques,including random and fixed effects models,were used to calculate combined effect size correlations and significance levels. Results:Seven studies were included,with total 144 newborns,144 cases in Hydrocortisone group and 93 cases in Hydrocortisone and inotrope group. Random effects meta-analysis showed that hydrocortisone increases blood pressure (r = 0.74,95%CI:0.16 to 0.91) and reduces vasopressor requirement (r = 0.72,95%CI:0.0124 to 0.96). Conclusion:Hydrocortisone is effective in treatment of refractory hypotension and decreasing vasopressor requirements in preterm without an increase in short term adverse consequences. However,the long term safety data on the use of hydrocortisone is unknown.