Objective　To explore the efficacy and safety of different maintenance doses of caffeine citrate in the treatment of apnea in premature infants by meta-analysis. Method　The databases of PubMed, The Cochrane Library, OVID, EMbase, Web of Science, CBM, VIP, WanFang and CNKI were searched from construction to June 2017, and randomized controlled trials (RCT) about high maintenance dose [10~20 mg/(kg·d)] and low maintenance dose [5~10 mg/(kg·d)] of caffeine citrate in the treatment of premature infants with apnea were included. RevMan 5.3 and Stata 12 were used for meta-analysis. Results　A total of 8 RCT were included, including 1000 children. Meta-analysis showed the effective rate (RR=1.30, 95%CI: 1.09~1.56, P=0.003) and the rate of tachycardia (RR=2.23, 95%CI: 1.34~3.73, P=0.002) in high-dose caffeine group were higher than those in low-dose caffeine group, and the failure rate of extubation (RR=0.50, 95%CI: 0.35~0.71, P=0.0001) and the incidence of bronchopulmonary dysplasia (RR=0.82, 95%CI: 0.70~0.95, P=0.01) were lower than those of the low maintenance dose of caffeine group, and there were significantly differences (P＜0.05). There was no difference in the incidence of other adverse reactions between the two groups (P＞0.05). Conclusion　High-dose caffeine citrate in the treatment of apnea in premature infants is better and safer than low doses.