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Dexmedetomidine showed some potential in pain control in patients undergoing knee arthroscopy. We conducted a systematic review and meta-analysis to explore the efficacy of dexmedetomidine in patients undergoing knee arthroscopy.We searched the randomized controlled trials (RCTs) assessing the effect of dexmedetomidine on knee arthroscopy in PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. The primary outcome was pain scores. Meta-analysis was performed using the random-effect model.Five RCTs were included. Overall, compared with control intervention in patients with knee arthroscopy, dexmedetomidine intervention could significantly reduce the pain scores [Std. mean difference = −0.84; 95% confidence interval (95% CI) = −1.24 to −0.44; P < .0001] and postoperative diclofenac sodium consumption (Std. mean difference = −1.76; 95% CI = −3.32 to −0.21; P = .03), improve duration of analgesic effect (Std. mean difference = 1.78; 95% CI = 0.56–3.00; P = .004), but showed no influence on hypotension [risk ratio (RR) = 0.93; 95% CI = 0.14–5.92; P = .94], bradycardia (RR = 4.93; 95% CI = 0.91–26.58; P = .06), nausea, and vomiting (RR = 1.96; 95% CI = 0.31–12.58; P = .48).Dexmedetomidine intervention was able to significantly reduce the pain scores and postoperative diclofenac sodium consumption, and improve duration of analgesic effect in patients undergoing knee arthroscopy, but had no influence on hypotension, bradycardia, nausea, and vomiting.