Abstract: Objective To assess distributions of carotid plaque in patients with atherosclerosis in the carotid arteries. Methods We electronically searched the Cochrane Library, CENTRAL, MEDLINE, EMBASE, SCI, CBM and CNKI databases; we also hand-searched some published and unpublished references and meeting papers. Languages were restricted to Chinese and English. We strictly adopted references according to inclusion criteria. The studies were evaluated by literature methodology. The Cochrane Collaboration’s RevMan 5.1 software was used for meta analysis. Results We identified 5 randomized control trials after comprehensively searching and selecting. The results showed statistically significant differences in carotid plaque distributions, and the incidence of those with plaque in the left side was higher than the right side, OR=0.72, 95%CI （0.67, 0.78）, P<0.000 01. Conclusions Compared with the right side, the plaque formation in the left side of common carotid artery were more frequency, while the distribution of left side might be indicated the degree of atherosclerosis than the right side. There were some criteria not included in this systematic evaluation, and thus more high quality RCT should be recruited and assessed in future study.