Objective To evaluate the effect of thoracic paravertebral nerve block (TPVB) and erector spine plane block (ESPB) for postoperative analgesia of video⁃assisted thoracic surgery by Meta⁃analysis. Methods PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang Data, VIP, and CBM were searched. All randomized controlled trials (RCT) comparing TPVB and ESPB for postoperative analgesia of video⁃assisted thoracic surgery were collected. The retrieval time limit was from the establishment of the database to May 2021. Two researchers independently assessed the quality of trials and extracted data. The primary outcomes were the postoperative Visual Analogue Scale (VAS) scores at rest and during cough 1, 2, 4, 6, 8, 12, 24 and 48 h after surgery. The secondary outcomes were the puncture time, the rate of rescue analgesia within 24 h after surgery, the number of effective compression of the analgesic pump within 48 h after surgery, the use of opioids at 24 h and 48 h after surgery and the incidence of postoperative analgesic related adverse reactions. Statistical analysis was performed by RevMan 5.4 software. Results Fourteen RCT involving 895 patients were included. Compared with ESPB, TPVB showed remarkable decreases in VAS scores at rest 12 h after surgery [standardized mean difference (SMD) −0.66 [95% confidence interval (CI) −1.25，−0.07], P<0.05], during cough 1 h after surgery [SMD −1.18 (95%CI −2.05, −0.31), P<0.05], during cough 6 h after surgery [SMD −0.96 (95%CI −1.71, −0.21), P<0.05] and during cough 12 h after surgery [SMD −0.85 (95%CI −1.36, −0.34), P<0.05]. There was no statistical difference in VAS scores at rest and during cough at other postoperative time points. There was no statistical difference in opioid dosages between the two groups 24 h after surgery (P>0.05) and the opioid use of TPVB was lower than ESPB 48 h after surgery [SMD −0.44 (95%CI −0.71,−0.17), P<0.05]. The incidence of rescue analgesia of TPVB within 24 h after surgery was lower than ESPB [odd radio (OR) 0.67 (95%CI 0.47, 0.97), P<0.05] and the puncture time of TPVB was significantly longer than ESPB [SMD 1.69 (95%CI 0.82, 2.56), P<0.05]. There was no statistically significant difference in the number of effective compression of the analgesic pump within 48 h after surgery and the incidence of postoperative analgesic related adverse reactions. Conclusions TPVB is better than ESPB in the early (24 h) postoperative analgesia, and there is no significant difference between the two methods in the long⁃term postoperative (48 h) analgesia. ESPB puncture time is significantly lower than TPVB, and does not increase the incidence of analgesia⁃related adverse reactions.