Objective: To evaluate the efficacy of using enhanced recovery after surgery (ERAS) protocols in perioperative management of pancreaticoduodenectomy (PD). Methods: The studies comparing the use of ERAS protocols and conventional protocols in perioperative management of PD were collected by searching several national and international literature databases. After literature screening according to the inclusion and exclusion criteria, Meta-analysis was performed by using the Review Manager 5.3 software. Results: Four randomized controlled trials and 11 clinical controlled trials were finally included, involving 2 185 patients, with 1 036 cases in ERAS group and 1 149 cases in non-ERAS group. The results of Meta-analysis showed that the length of postoperative hospital stay was significantly reduced (MD=–4.38, 95% CI=–4.73– –4.04, P<0.000 01), the time to the first postoperative flatus (defecation) was significantly shortened (MD=–1.34, 95% CI= –2.33––0.35, P=0.008), and the overall incidence of postoperative complications was significantly decreased (RR=0.66, 95% CI=0.57–0.75, P<0.000 01) in ERAS group compared with non-ERAS group; there were no significant differences in terms of the incidence of postoperative delayed gastric emptying, pancreatic fistula and biliary fistula, as well as in-hospital mortality and readmission rates (all P>0.05). Conclusion: Current evidence indicates that ERAS can promote bowel function recovery, decrease length of hospital stay and incidence of postoperative complications in patients undergoing PD. So it is recommended to be used in clinical practice.