Objective To evaluate the efficacy and safety of tandospirone citrate in the treatment of functional dyspepsia. Method Randomized controlled trials (RCT) of tandospirone citrate in the treatment of functional dyspepsia were searched in databases including CNKI，Wan Fang，VIP，PubMed，Web of Science，Google Scholar and Clinical Trials，from the inception of these databases to August 2020. The methodological quality of the included RCTs was evaluated via the Cochrane Risk of Bias tool，and the RevMan 5.3 software was used for Meta-analysis. Result 8 RCTs were included，involving 746 patients with FD. The experimental group included 380 patients (using tandospirone alone or tandospirone in combination with other drugs)，and the control group included 366 patients (using placebo or other drugs except tandospirone). The random sequence method was utilized in 6 RCTs，and the sequence were generated according to admission or visit order in other 2 studies. There were cases of lost to follow-up or drop-outs in some RCTs，which did not significantly affect the results due to the small number of these cases. All RCTs reported key outcomes of FD，which made selective reporting bias in a low risk. Meta-analysis results indicated that the overall effective rate in experimental group was significantly higher than the control group (OR:5.25

95%CI:3.65 ~ 7.56，P＜0.00001)，and the incident of adverse reaction has no significant difference between experiment group and control group (OR:1.58

95%CI:0.52 ~ 4.77，P = 0.42). Whereas，more adverse reactions could happen when tandospirone combined with other 5-HT receptor agonists (e.g. Mosapride). Conclusion Compared with conventional treatment，tandospirone citrate is effective in the treatment of functional dyspepsia，especially functional dyspepsia with anxiety，and the rate of adverse reactions is lower. Meanwhile，it is recommended to evaluate tandospirone in combination with other 5-HT agonists to reduce the incidence of adverse reactions.