Aim: This meta-analysis compared incidence of grade 3–4 neutropenia with ALK inhibitors versus chemotherapy in patients with non-small-cell lung cancer. Materials & methods: PubMed/MEDLINE was searched to identify Phase II and III randomized clinical trials published up to 25 October 2018. Summary incidence, relative risk and corresponding 95% CIs were calculated for grade 3–4 neutropenia. Results: Five randomized clinical trials were included. Relative risk (95% CI) of developing grade 3–4 neutropenia with ALK inhibitor versus chemotherapy was 0.27 (0.07–1.06). Probabilities of developing grade 3–4 neutropenia were 6.56 and 14.19%, respectively; no significant difference was found. Conclusion: In patients with non-small-cell lung cancer, incidence of grade 3–4 neutropenia with ALK-targeted therapy is not significantly different compared with chemotherapy.