Objective: To systematically review the effectiveness and safety of the use of enhanced recovery after surgery (ERAS) in the setting of liver surgery. Methods: The randomized controlled trials (RCTs) regarding using ERAS in the setting of liver surgery were collected by searching several national and international online databases. The retrieval time was from inception of the database to June 2015. Article screening, data extraction and quality assessment were performed by two independent reviewers according to the defined inclusion and exclusion criteria, and then, Meta-analysis was performed by using RevMan 5.3 software. Results: Nine RCTs were finally selected with a total of 1 140 patients composed of 555 cases in ERAS group and 585 cases (undergoing traditional perioperative management) in control group. The results of Meta-analysis showed that in ERAS group compared with control group, the incidence of postoperative complications (RR=0.58, 95% CI=0.45–0.75, P<0.05), length of hospital stay (WMD=–2.47, 95% CI=–3.14––1.79, P<0.05), time to first flatus (SMD=–0.90, 95% CI=–1.43––0.36, P<0.05), hospitalization costs (SMD=–0.91 95% CI= –1.38––0.44, P<0.05), and intraoperative blood loss (WMD=–22.64, 95% CI=–41.23––4.05, P<0.05) were all significantly decreased. There were no statistical differences between the two groups in respects of the incidence of postoperative bleeding, bile leakage, liver failure, pleural effusion as well as operative time (all P>0.05). Conclusion: Use of ERAS protocols in the setting of liver surgery is safe and effective, and it can also reduce the length of hospital stay and incidence of postoperative complications, and thereby accelerate postoperative recovery of the patients.