Abstract: Objective To evaluate the efficacy and safety of Epalrestat injection for diabetic nephropathy. Methods We searched the following databases: The Cochrane Library, PubMed, EMBASE, CNKI, Wanfang Data, VIP and CBM to collect the randomized controlled trials （RCTs） of Epalrestat curing diabetic nephropathy from inception to August 2013.References of included studies were also retrieved.Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality.Then, meta-analysis was performed using RevMan 5.1 software.Results The literature included 10 RCTs with a total of 724 cases.Among them, 365 cases belonged to the treatment group and the control group included 359 patients.The results of meta-analyses indicated that Epalrestat was superior to routine treatment in decreasing UAERMD=-82.16,95%CI （-110.30, -54.02）, P< 0.000 01, 24 hours total urinary protein and urine β 2-MG/Cr level, but there is no significant difference in the level of SCr and BUN. Conclusion The treatment of the diabetic nephropathy of Epalrestat is superior to the conventional therapy.However, because of few high quality literature and limited sample size, further study is needed.