Objective To evaluate the clinical efficacy and safety of octreotide in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).Methods Databases including CNKI, VIP, PubMed, CBM and Web of Science were searched against to find the randomized controlled trials (RCTs) on the effect of octreotide in the treatment of EPISBO. The study quality and risk of bias were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions, and the data were analyzed by Review Manager 5.2 software.Results A total of 13 RCTs with 916 patients were included. The results of meta-analysis showed that the octreotide reduced the gastric drainage volume [WMD = -403.30 (95% CI: -532.99, -273.62)], shortened the time to first flatus [SMD = -1.33 (95% CI: -1.75, -0.91)], and shortened the length of hospital stay [WMD = -4.19 (95% CI: -5.79, -2.59)]. In addition, octreotide did not increase the risk of adverse drug events.Conclusions The clinical efficacy of octreotide is better than the routine treatment for EPISBO. Changing the route of administration of octreotide may lower the risk of adverse drug events.