Objective To evaluate the effectiveness and safety of nasogastric decompression after elective surgery for colon and rectum neoplasms. Methods A comprehensive search of Chinese and English-language medical literatures was performed to identify all published randomized controlled trials (RCTs) evaluating the nasogastric decompression after elective surgery for colon and rectum neoplasms. Selection of literatures was done according to the inclusion and exclusion criteria, and the clinical data were extracted from each trial to perform the meta-analysis. Results Six RCTs (736 patients) fulfilling the inclusion criteria were included in the present analysis, and most trials showed comparable characteristics in their patient groups at baseline. Patients in non-NGD group had a shorter recovery time of gastrointestinal function (WMD=-1.15,95%CI\[-1.87--0.43\],P=0.002), shorter hospital stay (WMD=-2.43,95%CI\[-3.75--1.10\],P=0.000 3), and less respiratory infection (RR=0.17,95%CI\[0.03-0.95\],P=0.04), though more vomiting (RR=2.12,95%CI\[1.19-3.78\],P=0.01). No significant differences were noted in wound infection (RR=0.76,95%CI\[0.29-1.99\],P=0.58)or nasogastric tube replacement (RR=1.85,95%CI\[0.89-3.88\],P=0.10).Conclusion It is safe to give up NGD after elective surgery for colon and rectum neoplasms; routine use of NGD is not necessary because it does no more benefits to patients but increases the complications such as respiratory infection.