Objective: To systematically assess the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic-assisted surgery (LAS) in treatment of colorectal cancer. Methods: The randomized controlled trials and non-randomized comparative studies comparing HALS and LAS for colorectal cancer were collected by searching several national and international databases. After screening for inclusion, quality assessment and data extraction, Meta-analysis was performed by the RevMan 5.3 software. Results: A total of 27 studies involving 3 347 patients were finally included, with 1 626 cases in HALS group and 1 721 cases in LAS group. Results of Meta-analysis showed that in HALS group compared with LAS group, the operative time (WMD=–24.18, 95% CI=–31.61––16.75) was shortened, conversion rate (OR=0.57, 95% CI=0.41–0.81) and incidence of intraoperative injuries (OR=0.48, 95% CI=0.29–0.78) were decreased, the number of trocars used was reduced, but the length of incision (WMD=1.07, 95% CI=0.64–1.50) was increased, and all differences had statistical significance (all P<0.05). There was no statistically significant difference between the two groups in terms of postoperative recovery, incidence of postoperative complications, oncological outcomes, follow-up results, postoperative pain and hospitalization costs (all P>0.05). Conclusion: HALS can be considered as an alternative for colorectal cancer, which combines the advantages of minimal invasiveness of LAS and direct view of open surgery.