Objective: To assess the safety, efficacy and minimal invasiveness of totally laparoscopic distal gastrectomy (TLDG). Methods: The English literature comparing TLDG and laparoscopically assisted distal gastrectomy (LADG) publicly published from January 2007 to August 2013 were searched from several international online databases. After screening for inclusion, data extraction, and quality assessment, Meta-analysis was conducted by the Review Manager 5.2 software. Results: Five studies were finally included, with a total of 849 patients, of whom, 359 cases underwent TLDG and 490 cases were subjected to LADG. Results of Meta-analysis indicated that TLDG, compared with LADG, had decreased intraoperative blood loss, increased number of removed lymph nodes, and shortened length of time to postoperative flatus and first liquid intake (all P<0.05), but showed no significant difference in operative time, length of proximal surgical margin, length of postoperative hospital stay or incidence of complications (all P>0.05). Conclusion: TLDG is safe, effective and minimally invasive in treatment of distal gastric cancer, with no increase of postoperative complications.