Abstract: OBJECTIVE To compare the efficacy and costs of terlipressin and noradrenaline for the treatment of patients with cirrhosis and hepatorenal syndrome(HRS). METHODS Evidence-based medicine method was used to collect randomized-controlled trials for treatment of HRS with terlipressin and noradrenaline. Meta-analysis was performed to obtain the rate of HRS reversal, 30 d survival and adverse events. Economic evaluation was carried out by decision tree model. RESULTS Six randomized-controlled trials(225 patients) were included in the meta-analysis. There was no difference between treatments with terlipressin or noradrenaline in terms of HRS reversal and 30 d survival, had therapeutic equivalence. The rate of adverse reaction were less lower in noradrenaline group compared with terlipressin group. Expected costs of treatment with terlipressin and norepinephrine were 8 085.92 yuan and 890.37 yuan, respectively. Sensitivity analysis showed that the results were stable. CONCLUSION Noradrenaline combined with albumin has a cost-effectiveness superiority in the treatment of liver cirrhosis and HRS. It is recommended that the national health insurance department take the program into full-payout medical insurance and reduce the medical burden of the patients.