Ｏｂｊｅｃｔｉｖｅ　To systemically evaluate the clinical recovery differences between beating heart surgery and arrested heart surgery during mitral valve replacement.　Methods　Using the Cochrane systematic review methods, we searched the Cochrane Controlled Trial Registers(CCTR) of the Cochrane Library, PubMed, EMBASE, CNKI and Wanfang databases concerning the comparison of clinical recovery of beating heart surgery and arrested heart surgery during mitral valve replacement from inception to December 2016. Two reviews independently selected studies and assessed the quality of the trials. Disagreements were resolved by discussion, in consultation with a third reviewer. Then, Meta-analysis was performed using RevMan 5.3 software.　Results　Seven original randomized controlled trial (RCT) investigated a total of 242 patients, of whom 116 received beating heart surgery and 126 received arrested heart surgery, which met the inclusion criteria. Meta analysis results show that the frequency of defibrillation during operation [odds ratio(OR)=0.10, 95%CI(0.03, 0.29), P＜0.05] and usage of vasoactive agents after operation [weighted mean differences(WMD)=-2.71, 95%CI(-3.10, -2.32), P＜0.05] were less in beating heart surgery. In addition, the CPB time [WMD=-13.29, 95%CI(-21.97, -4.61), P=0.003] and length of ICU stay [WMD=-7.73, 95%CI(-10.92, -4.54), P＜0.05] were shorter in beating heart surgery, as compared to the arrested heart surgery. However, there were no significant differences between the two groups in operative time [WMD=-9.69, 95%CI(-26.15, 6.78), P=0.25], mechanical ventilation time [WMD =-4.39, 95%CI(-10.01, 1.23), P=0.13], post-operatively hospital stay [WMD=-1.12, 95%CI(-2.24, 0.01), P=0.05] and death toll during hospital stay [OR=2.48, 95%CI(0.34, 18.11), P=0.37].　Conclusions　During mitral valve replacement, the clinical recovery of beating heart surgery is better than recovery of arrested heart surgery in the frequency of defibrillation, usage of vasoactive agents after operation, CPB time and length of ICU stay. But the operative time, mechanical ventilation time, post-operatively hospital stay and death toll during hospital stay did not show significant differences between the two groups.