ObjectiveTo determine teratogenicity of beta-blockers in early pregnancy. MethodsWe searched PubMed, EMbase, Cochrane Clinical Trials, clinicaltrials.gov, CBM, Wanfang database, and CNKI from establishment of each database to December 2014. We evaluated the quality of included literature. Statistical analysis was conducted in RevMan5.3 software. ResultsFifteen population-based case-control or cohort studies were identified. The score of included studies changed from 5-7 points. Based on meta-analysis, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies. While in analysis examining organ-specific malformations, statistically increased odds of cardiovascular (CV) defects with OR 2.21 and 95% CI 1.63 to 3.01, cleft lip/palate (CL/P) with OR 3.11 and 95% CI 1.78 to 9.89, and neural tube (NT) defects with OR 3.56 and 95% CI 1.19 to 10.67 were observed. ConclusionCausality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.