ObjectiveTo systematically review the effectiveness and safety of combined spinal-epidural anesthesia for cesarean section. MethodsWe searched The Cochrane Library (Issue 10, 2013), PubMed, MEDLINE, EMbase, CBM, CNKI, VIP and WanFang Data for randomized controlled trials on combined spinal-epidural anesthesia for cesarean section up to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.2.9 software. ResultsA total of 9 studies containing 616 delivery women were included. The results of meta-analysis showed that:compared with epidural anesthesia, combined spinal-epidural anesthesia was superior in the time of sensory blockade to T4 (MD=-7.38, 95%CI-9.54 to-5.23, P < 0.000 01), muscle relaxation (OR=6.09, 95%CI 2.65 to 13.97, P < 0.000 1), and recovery of motor block (MD=-41.57, 95%CI-58.98 to-24.17, P < 0.000 01). Compare with spinal anesthesia, combined spinal-epidural anesthesia was superior in lowering the incidence of low blood pressure (OR=0.49, 95%CI 0.29 to 0.81, P=0.006). ConclusionCurrent evidence shows that combined spinal-epidural anesthesia could increase the effectiveness and safety of combined spinal-epidural anesthesia for cesarean section.