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OBJECTIVE: To evaluate the clinical effects of alprostadil injection in the treatment of diabetic foot ulcer. METHODS: The Cochrane Library, Embase, PubMed, CNKI, Wanfang Data and VIP databases were retrieved to collect the randomized controlled trial of alprostadil injection in the adjuvant treatment of diabetic foot ulcer (the control group received routine treatment of diabetes foot, and the observation group received alprostadil injection on the basis of routine treatment, regardless of whether it was combined with other drugs). The retrieval time was from the establishment of the database to Dec. 2023. Meta-analysis was performed by using RevMan 5. 3 statistical software. RESULTS: According to the literature selection criteria, 18 articles were finally included. Compared with the control group, patients in the observation group had higher total effectiveness (OR = 5. 79, 95%CI = 3. 88-8. 64, P<0. 000 01), faster flow velocity of dorsalis pedis artery (SMD= 0. 96, 95%CI = 0. 59-1. 33, P<0. 000 01), larger internal diameter of dorsalis pedis vessels (SMD= 0. 73, 95%CI = 0. 44-1. 01, P<0. 000 01), faster conduction velocity of superficial peroneal nerve (SMD= 2. 66, 95%CI = 1. 15-4. 16, P = 0. 000 5), smaller foot ulcer (SMD = -3. 42, 95%CI = -6. 40--0. 44, P = 0. 02), higher resistance index (SMD= 1. 20, 95%CI = 0. 16-2. 24, P= 0. 02), higher beat index (SMD= 2. 23, 95%CI = 0. 36-4. 11, P = 0. 02), better improvement of pain (SMD = -11. 68, 95%CI = -20. 21--3. 15, P = 0. 007), numbness (SMD= -19. 41, 95%CI = -29. 00--9. 81, P<0. 000 1), lameness (SMD= -14. 10, 95%CI = -22. 26--5. 94, P= 0. 000 7) and other symptoms, with statistically significant differences. CONCLUSIONS: Alprostadil injection in the treatment of diabetic foot ulcer can improve the total therapeutic effect, dilate the dorsalis pedis artery, accelerate the blood flow rate of dorsalis pedis artery, reduce blood resistance, promote the healing of ulcer surface, and improve the clinical symptoms of patients, which is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]