Abstract: Objective To systematically review the efficacy of microfracture versus autologous chondrocyte implantation for treatment of cartilage defects. Methods Databases including PubMed, EMBASE, the Cochrane library（Issue 5,2017）,CBM,CNKI and Wanfang data were electronically searched to collect randomized controlled trials（RCTs）about microfracture versus autologous chondrocyte implantation for treatment of cartilage defects from inception to May 2017. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies. Then,meta-analysis was performed using RevMan 5.3 software. Results A total of 7 RCTs involing 555 patients were included. The results of meta-analysis showed that KOOS scores at final follow-up in the microfracture group is less than that of autologous chondrocyte implantation group with significant difference（MD=-4.23,95%CI -8.39~-0.06,P=0.05）. There were no significant difference between both groups in Tegner scores at final follow-up（MD=-0.13,95%CI=-0.82~0.56,P=0.72）, Lysholm scores at final follow-up（MD=-7.21,95%CI -20.19~5.77,P=0.28）and available scores at 2-years follow-up（SMD=-0.50,95%CI -1.05~0.05,P=0.08）. Conclusion These findings demonstrate that microfracture result in same outcome with autologous chondrocyte implantation. However,whether microfracture owns a same long-term outcome with autologous chondrocyte implantation in general needs more research.