Objective To evaluate whether sentinel lymph node biopsy(SLNB)can be used in breast cancer patients following neoadjuvant chemotherapy (NCT) by systematically reviewing the published literatures. Methods The databases CBM, PubMed, Medline and Embase were searched using "breast cancer", "neoadjuvant chemotherapy" and "sentinel lymph node biopsy" as free words and MeSH terms for related literatures. The papers were selected strictly in accordance with the inclusion and exclusion criteria. The studies were divided into axillary lymph node-negative group and axillary lymph node-positive group according to the status of axillary lymph node before NCT. The data of the included researches were extracted and were then merged using STATA to estimate the identification rate and false-negative rate of SLNB in this setting. Results Forty-one studies were identified which involving a total of 5 848 patients. Lymph node-negative group contained 2 050 patients, and 1 891 of them were successfully detected in more than one sentinel lymph node, with the detecting rate and the false-negative rate being 0.94 (95% CI = 0.92-0.96) and 0.07 (95% CI = 0.04-0.10), respectively. Lymph node-positive group contained 3 798 patients, and 3 059 of them were successfully detected in more than one sentinel lymph node, with the detecting rate and false-negative rate being 0.87 (95% CI = 0.84-0.90) and 0.13 (95% CI = 0.11-0.16), respectively. Conclusion SLNB is reliable for women with lymph node-negative breast cancer receiving neoadjuvant chemotherapy. But it is not recommended for those with lymph node-positive breast cancer.