ObjectiveTo systematically revise the efficacy and safety of tamsulosin in treatment of proximal ureteral calculi. MethodsElectronic search was conducted with PubMed, Cochrane library, EMBASE, Wanfang database, CNKI and VIP to collect randomized controlled trials(RCTs) involving the application of tamsulosin in treatment of upper ureteral calculi. The quality of the included trials was assessed; the data were extracted and analyzed with RevMan 5.0 software. ResultsFive RCTs involving 480 patients were identified. The results of meta-analysis showed that, compared with the control group, patients in the tamsulosin group had (1) a remarkably higher stone clearance rate (RR=1.25,95%CI:1.12-1.40, P<0.000 1), (2) shorter mean time of calculi expulsion (shortened by 2.99 days, 95%CI: -3.61--2.37, P<0.000 01), and (3) decreased incidence of renal colic episodes and mean visual analogue scale pain score (RR=0.39,95%CI:0.26-0.57, P<0.000 01; WMD=-10.94,95%CI: -21.30--0.58, P=0.04).ConclusionOur results show that tamsulosin can improve the stone clearance, shorten the mean time for calculi expulsion, decrease the incidence of renal colic episodes and the mean visual analogue scale pain score in patients with proximal ureteral calculi.