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Objective: To systematically review the efficacy and safety of Buzhong Yiqi Tang (BZYQT) for the treatment of stable chronic obstructive pulmonary disease (COPD).Methods: Three electronic English databases (PubMed, EMBASE and CENTRAL)and four Chinese databases (CBM, CNKI, VMIS and WFMO) were searched from their inceptions until 30th April 2014.Participants were diagnosed with COPD according to the Chinese medical associations COPD diagnosis and treatment guidelines or Global Initiative for Chronic Obstructive Lung Disease (GOLD), and they were in stable stage.Randomized controlled trials of oral BZYQT, given alone or in combination with conventional therapy, pulmonary rehabilitation, when compared with placebo, pulmonary rehabilitation or conventional therapy were included in the review.Clinical improvement was chosen as the primary outcome.The Cochrane Risk of Bias tool was used to assess methodological quality.Data were analyzed using RevMan 5.3.0 software.Results: Twelve studies involving 900 participants were included.The results of meta-analysis indicate patients receiving BZYQT alone or BZYQT in combination with conventional therapy showed a significant increase in clinical improvement (RR 1.38, 95% CI 1.23 to 1.54) and reduced respiratory muscle fatigue (MD 0.46, 95% CI 0.11 to 0.80) when compared with conventional therapy alone;BZYQT plus pulmonary rehabilitation improved quality of life (Cais Questionnaire) compared with pulmonary rehabilitation alone (MD-0.62, 95% CI-0.73 to-0.52).BZYQT also showed small but significant improvements in exercise capacity and decreased acute exacerbations of COPD.Three studies reported that no adverse events occurred, other studies did not mention the adverse events.Interpretation of research results needs to be considered with caution because the included studies had methodological shortfalls.Conclusions: BZYQT improves clinically important outcomes for patients with stable COPD.However further evaluation is still needed to validate these preliminary finding in high quality randomized controlled trials.