Abstract: OBJECTIVE To evaluate the efficacy and safety of fasudil on cerebral vasospasm in subarachnoid hemorrhage. METHODS The therapeutic and preventive effect of fasudil, as well as the effect of improving clinical outcome in subarachnoid hemorrhage was estimated through system evaluation and meta-analysis of clinical controlled trials. RESULTS Nine studies met the incorporating standard. The experimental observation of different index in 832 patients was accomplished. Ratio of cerebral vasospasm that had clinical symptom or which was diagnosed with digital subtraction angiography in fasudil group was only 48%(OR=0.48, P=0.000 5) and 40%(OR=0.40, P=0.000 4) of that of control group. Ratio of cerebral infarction caused by all reasons or that by cerebral vasospasm in fasudil group was 50%(OR=0.50, P=0.000 9) and 43%(OR=0.43, P=0.000 8) of control group. To compare with control group, ratio of patients with complete recovery increased 107% in fasudil group. To compare with nimodipine, fasudil could ameliorated the level of consciousness significantly in patients that had been treated 2 weeks(fasudil versus nimodipine: WMD=0.95, P<0.000 01). There was no significant difference of adverse effects between 2 groups(P>0.05). CONCLUSION Fasudil could decrease the rate of cerebral vasospasm and cerebral infarction happening enormously in subarachnoid hemorrhage. Fasudil could ameliorate clinical outcome significantly in subarachnoid hemorrhage. Fasudil could improve the level of consciousness significantly in subarachnoid hemorrhage during acute stage. The ratio of adverse effects of fasudil and nimodipine was almost the same.