Background and Aims With the development of concept of fast-track surgery, perioperative multimodal analgesia has been gradually accepted. Among them, preemptive analgesia is a common method. This study was conducted to determine the efficacy and safety of parecoxib sodium preemptive analgesia in laparoscopic cholecystectomy (LC) through a systematic review and Meta-analysis.Methods The randomized controlled trails or observational studies comparing the preoperative intravenous injection of parecoxib sodium (preemptive analgesia) and without intravenous use of parecoxib sodium (blank control) or intravenous injection of parecoxib sodium at the end of operation (postoperative analgesia group) in LC were collected by searching several Chinese and English databases. The retrieval time from inception to May 2021. After the quality evaluation and data extraction of the included studies, Meta-analysis was performed by using RevMan 5.1 and Stata 12.0 software.Results Thirteen articles in Chinese and English were finally included, involving 974 patients. Results of Meta-analysis showed that the visual analogue score (VAS) at postoperative 2, 4, 6, 8, 12 and 24 h were lower in preemptive analgesia group than those in blank group (all P<0.05) and postoperative analgesia group (partial P<0.05); the number of patients requiring additional painkillers in preemptive analgesia group was less than that in blank group or postoperative analgesia group, and the incidence of postoperative adverse reactions (nausea and vomiting) in the preemptive analgesia group was lower than that in the blank group (all P<0.05). Results of publication bias sensitivity analysis based on the number of cases requiring additional painkillers and the incidence of postoperative adverse events showed that there was no significant publication bias (both P>0.05), and this method would not change the results of the initial overall analysis.Conclusion Preemptive analgesia with intravenous injection of parecoxib sodium in LC has netter analgesic efficacy with low adverse effect. It provides a safe and effective alternative for clinical multimode analgesia.