Background and Aims Although many animal experiments have confirmed that remote ischemic preconditioning (RIPC) can significantly improve the early tissue perfusion and oxygenation of the residual liver after hepatectomy, reduce the hepatic ischemia-reperfusion injury (HIRI), accelerate the surgical prognosis, and improve the survival rate. However, there is still controversy over the role of RIPC in relieving HIRI in clinical studies. Therefore, this study was conducted to evaluate the efficacy and safety of RIPC in hepatectomy through Meta-analysis to provide evidence-based information for clinical decision-making.Methods Randomized controlled trials (RCTs) evaluating the efficacy and safety of RIPC strategy were collected by searching several national and international literature databases. The search spanned the period from the inception of each database to May 2022. After data extraction and quality evaluation of the included studies, Meta-analysis was performed using RevMan 5.3 software. The main evaluation indicators were postoperative liver function parameters, operative time, intraoperative blood loss, length of postoperative hospital stay, and the major postoperative complications.Results A total of 11 RCTs were included, involving 851 patients, with 422 cases in the RIPC group and 429 cases in the control group. The results of Meta-analysis showed that there was no significant difference in each liver function parameter before operation between the two groups (all P>0.05); the levels of alanine transaminase (ALT) and aspartate transaminase (AST) on postoperative day (POD) 1 were significantly lower in RIPC group than those in control group (WMD=-74.92, 95% CI=-126.18--23.67, P=0.004; WMD=-66.37, 95% CI=-106.47--26.27, P=0.001), but significant heterogeneity existed among the studies (I2=98%; I2=95%), there were no significant differences in ALT and AST levels on POD 3 and 7 between the two groups (all P>0.05), and there were no significant differences in levels of total bilirubin and albumin on POD 1, 3 and 7 between the two groups (all P>0.05); no statistical differences were noted in other evaluation indicators between the two groups (all P>0.05).Conclusion The application of RIPC in hepatectomy offers limited clinical benefit and cannot alleviate liver injury caused by HIRI after hepatectomy. However, more high-quality multicenter RCT studies still need to verify the above conclusions. In addition, all current clinical studies are performed under propofol anesthesia or propofol combined with inhalation anesthesia, which is also a hot topic of debate.