Objective: To compare the efficacy of extraperitoneal and transperitoneal colostomy after laparoscopic Miles’ procedure. Methods: The clinical studies comparing the efficacy of extraperitoneal and transperitoneal colostomy after laparoscopic Miles’ operation publicly published before August 2017 were collected by searching several national and international databases. Meta-analysis was performed on relevant variables by using RevMan 5.3 software. Results: A total of 15 studies involving 1 162 patients were included, with 615 cases in extraperitoneal group and 547 cases in transperitoneal group. The results of pooled Meta-analysis showed that except the increased incidence of stomal edema (OR=5.19, 95% CI=2.15–12.53, P=0.0002), the incidence of parastomal hernia (OR=0.10, 95% CI=0.04–0.22, P<0.00001), incidence of stoma necrosis (OR=0.37, 95% CI=0.16–0.86, P=0.02), incidence of stoma prolapse (OR=0.22, 95% CI=0.09–0.57, P=0.002), incidence of internal hernia (OR=0.23, 95% CI=0.06–0.81, P=0.02), incidence of stoma retraction (OR=0.25, 95% CI=0.07–0.81, P=0.02), and incidence of stoma mucocutaneous separation (OR=0.30, 95% CI=0.12–0.76, P=0.01) were all significantly decreased, with reduced length of postoperative hospital stay (MD=–0.70, 95% CI=–1.14––0.27, P=0.002) and improved sensation of defecation (OR=20.32, 95% CI=9.05–45.62, P<0.00001) in transperitoneal group compared with extraperitoneal group. There were no differences in variables that included stoma infection, operative time, time of colostomy creation, stoma constriction, intestinal obstruction, time to first postoperative gas passage, intraoperative blood loss, stoma bleeding and parastomal inflammation between the two groups (all P>0.05). Conclusion: Transperitoneal colostomy has better efficacy than that of extraperitoneal colostomy after laparoscopic Miles’ operation.