Abstract: OBJECTIVE To determine the correlation between the polymorphisms of rs6311 (-1438A>G) and rs6313(102T>C) of 5-HTR2A gene and the efficacy of anti-schizophrenia drugs by meta-analysis. METHODS The association of 5-HTR2A gene polymorphisms with the efficacy of anti-schizophrenia drugs were retrieved from PubMed, Embase, ScienceDirect, Web of Science, CNKI, Wanfang, Weipu, and the Chinese Biomedical Literature Database in the past two decades. Review Manager 5.3 was used to meta analysis. RESULTS A total of 27 articles were included. The meta-analysis was performed on the correlation between allele and genotype of rs6311 and rs6313 locus of 5-HTR2A gene and anti-schizophrenia drug treatment effectiveness and reductive ratio, and subgroup analysis was performed by three factors: time, drug, and region. Meta-merge analysis of the effectiveness data of rs6311 locus showed that the allele A>G polymorphism was not associated with the efficacy of anti-schizophrenia drugs, and the subgroup analysis showed that the efficiency of allele A patients in the Chinese population was higher. The reductive ratio data showed that the anti-schizophrenia drugs reductive ratio of AG genotype patients was higher than that of GG. For the rs6313 locus, the allelic T>C polymorphism was not associated with the efficacy of anti-schizophrenia drugs, while the genotype polymorphism was associated. The effectiveness of chlorpromazine treatment in patients with TC genotype was higher than that of TT. The reductive ratio data also showed that the reductive ratio of TC patient was higher than that of TT. Subgroup analysis also showed that the reductive ratio of genotype TC patients in the Chinese population was higher than that of TT. While, the CC genotype patients in other countries had a higher reductive ratio than TT. The reductive ratio of TC genotype patients in the risperidone treatment and 1999—2009 populations were both higher than that of CC. CONCLUSION The association between 5-HTR2A gene polymorphism and the efficacy of anti-schizophrenia drugs is affected by time, drug, and region. But overall, the rs6311 locus AG genotype and the rs6313 locus TC genotype are good predictors of anti-schizophrenia drugs.