Objective To compare the safety and efficacy of remimazolam and propofol in outpatient sedation for minor surgery by meta-analysis.Methods Pubmed,Web of Science,Cochrane Library,CNKI,Wanfang,and VIP databases weresearched by computer,and the search time was from the establishment of thedatabase to July 2022.The comparison of remimazolam and propofol in proce-dural sedation was included.In a randomized controlled trial (RCT) of safety and efficacy,the remimazolam group used remimazolam as an anesthetic,with or without other analgesics,and the propofol group used propofol in the same combination.Two researchers selected trials according to the inclusion and exclusion criteria,extracted data,and evaluated the quality of the included studiesaccording to the quality evaluation criteria provided by the Cochrane System Manual.RevMan5.3 software was used for meta-analysis.Results A total of 19 RCTs involving 2633 patients were included,including 1322 in the remimazolam group and 1311 in the propofol group.Meta-analysis results showed that the sedation effect of remimazolam is comparable to that of propofol(OR=0.68,95%CI0.09～4.96,P=0.70).Compared with propofol group,remimazolam could sign-ificantly increase hemodynamic stability MAP(MD=6.41mmHg,95%CI2.44～10.38mmHg, P=0.002),HR(MD=3.38per minute,95%CI1.43～5.32per minute,P0.001),re-duce the incidence of hypotension(OR=0.23,95%CI0.18～0.29,P0.001),the incid-ence of hypoxemia(OR=0.19,95%CI0.11～0.31,P0.001),incidence of injection pa-in(OR=0.04,95%CI0.01～0.1,P0.001), incidence of respiratory depression(OR=0.04,95%CI0.01～0.1,P0.001),incidence of bradycardia(OR=0.38,95%CI0.24～0.60,P0.001),and shortened recovery time after surgery(MD=-0.92min,95%CI-1.59～-0.26min,P=0.006)and time of leaving the chamber(MD=-2.46min,95%CI-3.89～-1.02min,P0.001),but the time to fall asleep after induction was significantly prol-onged(MD=0.16min,95%CI0.02～0.31min,P=0.03).There was no significant differe-nce in the incidence of dizziness(OR=0.60,95%CI0.34～1.06,P=0.08)and nausea and vomiting(OR=0.79,95%CI0.43～1.47,P=0.46)between the two groups.Conclus-ion Remimazolam is a safe and effective sedative drug for outpatient minor surgery,its sedative effect is not inferior to propofol,and the incidence of adv-erse reactions such as hypotension,hypoxemia,injection pain,respiratory depress-ion,bradycardia is lower.The incidence of postoperative nausea,vomiting and di-zziness is similar to that of propofol,and the postoperative recovery is faster, but the onset time after induction is significantly prolonged.