Abstract: 　Objective　To explore the efficacy of tacrolimus (TAC) and cyclosporine A (CsA) in the treatment of refractory nephrotic syndrome (RNS). Methods　The databases of PubMed, Cochrane Library, Wanfang, VIP, CNKI were searched to retrieve randomized controlled clinical trials published from January 2000 to June 2017. Meta-analysis was performed using RevMan 5.3 software using complete remission rate, overall remission rate and recurrence rate as indicators. Results　A total of 426 articles were retrieved. According to inclusion and exclusion criteria, 6 articles were finally included with 302 RNS patients in total. Meta-analysis showed that there were significant differences in complete remission rate (RR=2.01, 95%CI: 1.15~3.51, Z=2.44, P=0.01) and total remission rate (RR=2.53, 95%CI: 1.10~5.83, Z=2.19, P=0.03) while there was no difference in recurrence rate (RR=0.62, 95%CI: 0.30~1.27, Z=1.31, P=0.19) between TAC group and CsA group. Conclusion　Compared with CsA, TAC has certain advantage in improving the complete remission rate and total remission rate of RNS.