Objectives To evaluate the safety and effectiveness of endoscope-assisted and microscopy microvascular decompression（ EA-MVD and M-MVD） using meta-analysis. Methods Following the principle of evidence-based medicine， we searched databases（ e.g.， EMBase， Medline， Cochrane library， VIP， CNKI， Wan Fang） for studies of endoscope-assisted and microscopy microvascular decompression from January 1992 to January 2018. Studies that met the inclusion standard were meta-analyzed in RevMan 5.3. Results A total of 11 studies were included in the meta-analysis with a total sample of 1 040 patients. There was no significant difference in the operation time between the two groups（ P=0.88）. The occurrence of postoperative complications and one-year recurrence rate in the M-MVD group were higher than those in the EA-MVD group while the overall postoperative recovery rate and the one-year postoperative recovery rate in the M-MVD group were lower than those in the EA-MVD group. The OR combined values were 2.75（ 1.99-3.81）， 9.10（ 2.41-34.33）， 0.38（ 0.26- 0.55）， 0.36（ 0.20-0.64）， and the difference was statistically significant（ P＜ 0.05）. Conclusions Compared with M-MVD， EA-MVD is safer， more effective with a lower postoperative complication rate.