Objective To evaluate the effect of intravenous lidocaine on perioperative outcomes in patients with colorectal cancer by a meta-analysis. Methods PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), SinoMed and Wanfang databases were electronically retrieved to include randomized controlled trials (RCTs) on the effect of intravenous lidocaine on perioperative outcomes in patients with colorectal cancer before Feb. 18, 2021. The literatures were screened according to the inclusion and exclusion criteria, and then the data were extracted and the methodological quality was assessed. The data were analyzed using RevMan 5.4 software. Results A total of 12 studies involving 616 patients were included (307 cases with intravenous lidocaine and 309 cases as placebo control or blank control). Compared with the control group, intravenous lidocaine significantly reduced the scores of visual analogue scale (VAS) at 4 h (mean difference[MD]=-0.85, 95% confidence interval[CI] -1.29 to -0.42, P=0.000 1), 12 h (MD=-0.63, 95% CI-0.89 to -0.38, P<0.000 01), and 24 h (MD=-0.42, 95% CI-0.81 to -0.04, P=0.03) after surgery, shortened the time to pass the first flatus (MD=-9.48, 95% CI-12.17 to -6.78, P<0.000 01) and defecation (MD=-7.60, 95% CI-10.63 to -4.57, P<0.000 01), and decreased the incidence of postoperative nausea and vomiting (relative risk[RR]=0.39, 95% CI 0.26 to 0.58, P<0.000 01); however, there was no significant difference in the hospital stay (MD=-1.04, 95% CI-2.26 to 0.19, P=0.10). Conclusion Perioperative intravenous lidocaine can relieve the postoperative pain of patients with colorectal cancer, shorten the postoperative exhaust and defecation time, and reduce the incidence of nausea and vomiting, providing evidence-based basis for its clinical application.