Background: Chronic prostatitis (CP) is one of the most common diseases in urology. Longdanxiegan decoction (LDXGD), a classical formula of traditional Chinese medicine (TCM), has been widely used for chronic prostatitis patients with the damp invasion of lower energizer syndrome in China, and the effects were satisfactory. However, there is still no clear understanding of its clinical effects. Purpose: This study aimed to systematically evaluate the efficacy and safety of LDXGD for chronic prostatitis. Methods: Pubmed, EMBASE, Cochrane Library, China Biology Medicine disc (CBMdisc), China national knowledge infrastructure (CNKI), Wanfang, and VIP database were searched from their inceptions to August 11, 2022 to identify RCTs that inspected the efficacy of LDXGD on chronic prostatitis. Results: 12 trials totaling 1314 patients were identified for analysis. Meta-analysis showed that LDXGD treatment was more effective (RR=1.31, 95%CI (1.18, 1.45), P<0.00001) and cure rate (RR=1.79, 95%CI (1.52,2.12), P<0.00001) than western medicine. Meanwhile, LDXGD had reduced NIH-CPS score, such as the total score, pain domain score, urinary domain score, and QoL domain score. Besides, LDXGD was more effective in improving EPS - WBC count. LDXGD safety remained unknown. Conclusions: According to preclinical evidence, LDXGD could be an effective and promising treatment for chronic prostatitis. In addition, more well-designed studies are needed to confirm this conclusion. Trial registration: PROSPERO 2022 CRD42022347076.