Abstract: OBJECTIVE To assess the efficacy and safety of intranasal steroid sprays combined with mucolytics in the treatment of secretory otitis media. METHODS It was searched that articles in Wanfang database, CNKI and VIP databases, CBM, PubMed, EMBASE and Cochrane Library published until October 2013. Randomized controlled trails (RCT) included in research were assessed with Cochrane Collaboration Guideline, and the Meta analysis was done with the software RevMan 5.2. RESULTS Five RCT studies fulfilled the inclusion criteria were collected for Meta-analysis with a total sample size of 414 patients (562 ears), including 226 patients (311 ears) of treatment group and 188 patients (251 ears) of control. Meta-analysis showed that treatment with intranasal steroid sprays combined with mucolytics was more effective than conventional treatment OR=3.75, 95% CI(2.27, 6.18), P<0.000 01. CONCLUSION Intranasal steroid sprays combined with mucolytics is an effective therapeutic strategy for the patients with secretory otitis media. However, because of the rare relative researches, it needs further more large samples, multi-center studies to provide more sufficient evidences.