Objective: To evaluate the safety and efficacy of minimally invasive hepatectomy for hepatolithiasis. Methods: Literature regarding studies comparing minimally invasive hepatectomy and open hepatectomy for hepatolithiasis was collected through searching several national and international online databases. After data extraction, Meta-analysis was performed by using Stata 12.0 software. Results: Twenty-four studies were finally included involving 2 051 patients, of whom, 993 cases underwent minimally invasive hepatectomy and 1 058 cases underwent open hepatectomy. Results of Meta-analysis showed that minimally invasive hepatectomy had significantly reduced intraoperative blood loss (SMD=–0.867, 95% CI=–1.261––0.472, P<0.001), blood transfusion rate (OR=0.475, 95% CI=0.330–0.683, P<0.001), incidence of postoperative complications (OR=0.493, 95% CI=0.382–0.638, P<0.001), postoperative fasting time (SMD=–1.845, 95% CI=–2.609––1.082, P<0.001), length of postoperative hospital stay (SMD=–0.983, 95% CI=–1.323––0.643, P<0.001) and stone recurrence rate (OR=0.513, 95% CI=0.322–0.816, P=0.005) compared with open hepatectomy, while no significant differences were noted in operative time, initial stone clearance rate and final stone clearance rate between the two approaches (all P>0.05). Conclusion: Minimally invasive hepatectomy is a safe and effective approach for hepatolithiasis, and is superior to open hepatectomy in most intra- and postoperative variables. However, more randomized controlled trials are still needed to verify these differences.