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The effectiveness of intra‐aortic balloon pump (IABP) combined with venoarterial extracorporeal membrane oxygenation (VA‐ECMO) in patients with cardiogenic shock or cardiac arrest remains controversial. The aim of this systematic review and meta‐analysis was to investigate the short‐term clinical outcomes of IABP combined with VA‐ECMO versus VA‐ECMO alone. We searched PubMed, Embase, and the Cochrane Library for English language articles published from inception to August 18, 2018. Observational studies comparing IABP combined with VA‐ECMO with VA‐ECMO were considered eligible for the current study. Twelve observational studies with 3704 patients were included. In the IABP combined with VA‐ECMO group mortality was 59.7%, compared with 65.8% in the VA‐ECMO alone group. The risk ratio (RR) for this comparison was 0.90 (95% confidence interval [CI], 0.80–1.02; P = 0.107; 59.7% vs. 65.8%). In the one‐way sensitivity analysis for estimating the effect of each study on mortality, omission of each study did not make a significant difference. Furthermore, the proportion of patients weaned from VA‐ECMO was significantly higher in IABP combined VA‐ECMO group than in the VA‐ECMO alone group (RR, 1.28; 95% CI, 1.21–1.35; P < 0.001; 77.9% vs. 61.2%). IABP combined with VA‐ECMO could improve success rate of weaning from VA‐ECMO, but did not reduce in‐hospital mortality in patients with cardiogenic shock or cardiac arrest. [ABSTRACT FROM AUTHOR]