Abstract:-Background: Acetaminophen is one of the most treatments used to reduce the temperature in ICU patients. However, it is still unclear whether the use of acetaminophen improves patients' survival and hospital length of stay. This study aims to analyze the main literatures which studied the use of acetaminophen in ICU patients with fever due to infections or other non-infectious insults. Methods:Severaldatabases including Cochrane library database, Academic Search Complete, and PubMed were searched for studies on acetaminophen in ICU patients. The search was limited to randomized controlled trials, cohort studies, adult human critically ill patients, treatment with acetaminophen in one arm and no treatment (placebo) in the other arm. The outcomes assessed were the ICU and hospital length of stay, mortality rate, ICU-free days and changes in temperature. Results:Two randomized control trials and one cohort study covering 32,408 patients were included. There wereno differences in ICU and hospital length of stay between the group treated with acetaminophen and placebo. In addition, the mortality rate did not differ between the two groups in patients with fever due to infection; however, a difference was shown in patients with fever due to non-infectious insults. Finally, there was a significant reduction in temperature in acetaminophen group compared to placebo. Conclusion: The use of acetaminophen for fever in critically ill patients was not associated with better outcome in terms of ICU and hospital length of stay and mortality ratecompared to placebo especially when the fever is due to infections.