Objective:To assess the efficacy and safety of endoscopic orbital decompression systematically in treating Graves’ ophthalmopathy. Methods:Databases included the Cochrane Central Register of Controlled Trials,Medline from their inception to May,2013,and the relevant journals and references of articles were also retrospectively searched to collect randomized controlled trials (RCTs) or before-after self-controlled trials on endoscopic orbital decompression. Two reviewers independently screened the articles according to the predefined inclusive and exclusive criteria,and then extracted necessary data and evaluated quality of the included studies. Then meta-analysis were performed using RevMan 5.1.0. Results:A total of the 5 self-controlled trials involving 156 patients were finally included. The results of meta-analysis showed a significant reduction in proptosis without marked change in diplopia. However, the sight and the incidence of diplopia did not change significantly. Sensitivity analysis indicated that these results were stable. Conclusion:Endoscopic orbital decompression improved proptosis and ophthalmological function in Graves ophthalmothy. There is no evidence that endoscopic orbital decompression could increase the risk of new upset diplopia. However,prospective RCTs with larger scale and longer follow-up are still necessary to confirm this conclusion.