Objective To compare the clinical efficacy and safety between LARS system and autografts in anterior cruciate ligament (ACL) reconstruction. Methods The PubMed database, China National Knowledge Infrastructure (CNKI), Chinese biomedical literature database (CBMdisc), and Wanfang database were searched to obtain the published article comparing the LARS and autografts for ACL reconstruction. The references of the retrieved articles were also read for related articles. Results A total of 9 articles with 456 cases were included in this study.The results showed that Lysholm and Tegner scores were improved significantly after LARS replacement (Lysholm:MD=50.05, 95% CI 48.41-51.68; Tegner:MD=4.41; 95% CI 3.40-5.42). Compared with autografts, the improvements of Lysholm and Tegner scores for LARS replacement were more significant 2 years postoperatively (Lysholm:MD=0.20, 95% CI 0.04-0.35; Tegner:MD=0.18, 95% CI 0.04-0.32). Meanwhile, complication (such as synovitis) rate of LARS replacement was low 2 years postoperatively, showing no notable difference with that of autograft techniques. Conclusion The LARS artificial ligament is effective and safe for ACL reconstruction. LARS has more advantages than autografts concerning the stability 2 years postoperatively. However, high-quality studies with long-term follow-up are required for further confirmation.