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The efficacy of thoracic paravertebral block for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of thoracic paravertebral block on thoracoscopic surgery.We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2018 for randomized controlled trials (RCTs) assessing the effect of thoracic paravertebral block on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.Six RCTs involving 300 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, thoracic paravertebral block results in significantly reduced pain scores within 6 hours (Std. MD = −2.15; 95% CI = −3.67 to −0.62; P = .006), postoperative anesthesia consumption during 48 hours (Std. MD = −1.81; 95% CI = −3.05 to −0.58; P = .004), and hospital stay (Std. MD = −1.19; 95% CI = −2.13 to −0.26; P = .01), but has no important impact on pain scores at 24 hours (Std. MD = −1.10; 95% CI = −2.77–0.57; P = .20), and 48 hours (Std. MD = −1.25; 95% CI = −2.86–0.36; P = .13).Thoracic paravertebral block can substantially enhance pain management for thoracoscopic surgery.