Objective: To evaluate the efficacy and safety of laparoscopic and open splenectomy and esophagogastric devascularization for portal hypertension by means of systematic review. Methods: The literature of studies related to laparoscopic versus open splenectomy and esophagogastric devascularization was collected by searching the national and international online databases. The articles were screened according to the inclusion and exclusion criteria. After data extraction and quality assessment, Meta-analysis was performed by using RevMan 5.2 software. Results: No randomized controlled trial was found in the literature, and 11 non-randomized controlled clinical trials were finally included, with a total of 494 patients, of whom, 227 cases underwent laparoscopic surgery (laparoscopic group) and 267 cases were subjected to open surgery (laparotomy group). Compared with laparotomy group, the results of Meta–analysis showed that in laparotomy group, the operative time was prolonged, and the intraoperative blood loss, surgical complications and length of postoperative hospital stay was reduced, but the hospitalization costs were increased. All the differences reached statistical significance (all P<0.05). Conclusion: Compared with open surgery, laparoscopic splenectomy and esophagogastric devascularization has the advantages of reduced intraoperative blood loss, postoperative hospital stay and complications, but it has increased hospitalization costs and operative time. However, this conclusion should be considered cautiously, due to limitations in the quality and quantity of the included studies.