Objective: To evaluate efficacy and safety of denosumab in treatment of osteoporosis (OP) of rheumatoid arthritis (RA) patients by Meta analysis. Methods: Databases of PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP and CBM were searched for randomized controlled trials (RCT), prospective and retrospective comparative studies about denosumab in treatment of OP with RA patients published in domestic and foreign official journals from establishment of database to October 2021. Retrieved literatures were screened independently by two researchers, and methodological quality of included literatures was evaluated according to bias risk assessment tool recommended by Cochrane 5.1. Data were statistically analyzed by Revman 5.3. Results: A total of 1 399 patients from 8 articles in accordance with criteria were included, including experimental group( n=735) and control group (n=664). Meta analysis results showed that after 12 months of treatment, denosumab could effectively increase level of lumbar BMD in RA patients who have not been treated with BPs (MD=3.08, 95%CI: 1.73~4.42, P<0.000 01). However, compared with BPs drugs, there was no significant difference in effect of improving lumbar BMD of denosumab (MD=0.02, 95%CI: -0.03~0.06, P=0.49). Moreover, denosumab could protect joint and reduce Sharp score (MD=-0.53, 95%CI: -0.77~-0.29, P<0.000 1) and joint space narrowing score (MD=-0.12, 95%CI: -0.17~-0.06, P<0.000 1), inhibit bone erosion and reduce joint bone erosion score (MD=-0.49, 95%CI: -0.84~-0.15, P<0.005 0), had good application safety and incidence of adverse events was similar to control group (general adverse events: RR=1.05, 95%CI: 0.76~1.45, P=0.75; serious adverse events: RR=0.73, 95%CI: 0.52~1.04, P= 0.08; death event: P=0.36). Conclusion: Current evidence shows that denosumab can significantly increase BMD of lumbar vertebrae, reduce score of joint injury and bone erosion, alleviate joint space stenosis, inhibit bone erosion, protect joint to maximum extent, maintain joint function and has high safety. However, the conclusions of this study still need to be verified by a larger sample size and further extended research. [ABSTRACT FROM AUTHOR]