Objective To explore the clinical curative effect of sandplay therapy for autism spectrum disorder. Methods The randomized controlled trials（ RCTs） from Pubmed， Web of Science， Embase， Cochrane Library， PsycINFO， ScienceDirect， ProQuest， Google Scholar， CNKI， Wanfang database， VIP and Chinese Biomedical Database were searched from the inception to May 5， 2020. Two researchers independently performed literature search， data extraction， quality evaluation and risk assessment based on inclusion and exclusion criteria. Review manager 5.3 software was used to analyze the data of the included articles. Results A total of 11 randomized controlled trials were enrolled， including 853 patients. The result showed that sandplay therapy can decrease score of Autism Behavior Checklist（ ABC）（ MD=-10.06，95%CI=-12.35--7.77，P＜0.01）， decrease the score of Childhood Autism Rating Scale（ CARS）（ MD=-4.67，95%CI=-7.58--1.76，P=0.002）， decrease the score of Autism Treatment Evaluation Checklist（ ATEC）（ MD=-16.36，95%CI=-20.22- -12.50，P＜ 0.01）， and increase the score of Psycho-educational Profile 3（ PEP-3）（ MD=11.65，95%CI=7.89-15.42，P ＜ 0.01）. Conclusions The sandplay therapy has clinical efficacy in improving patients' psychological status， speech socialization and sensory cognition.