Objectives To evaluate the efficacy and safety of desloratadine in the patients with chronic urticaria(cu). Methods We searched PubMed, Blackwell, BIOSIS Preview, The Cochrane Library, VIP and CNKI electronically from January 1, 2000 to April, 2008. Relevant journals and conference proceedings were also handsearched. Randomized controlled trials (RCTs) and quasi-RCTs comparing desloratadine with other medicines in the patients with CIU were considered eligible. The quality of the included trials was assessed by the Jadad scale, and meta-analysis was conducted using RevMan 5.0 software. Results Nineteen trials involving 3,448 participants contributed to the meta-analysis. The results of the meta-analysis indicated that desloratadine showed similar effect on the improvement of signs and symptoms compared with loratadine RR 1.04 and 95%CI 0.99 to 1.09, mizolastine in RR 0.99 and 95%CI 0.92 to 1.07, cetirizine RR 1.05 and 95%CI 0.97 to 1.13 and terfenadine RR 1.10 and 95%CI 0.84 to 1.44. And desloratadine had similar safety to mizolastine RR 0.84 and 95%CI 0.45 to 1.58, ceririzine RR 0.67 and 95%CI 0.67 and 0.39 to 1.15 and terfenadine RR 0.44 and 95%CI 0.17 to 1.10. Desloratadine was safer than loratadine RR 0.74 and 95%CI 0.55 to 1.00. Conclusions Desloratadine, the active metabolite of loratadine, is an oral, once-daily, non-sedating antihistamine that is effective in the treatment of CIU. Desloratadine provides rapid and sustained relief of CIU symptoms.