Objective To systematically evaluate the effect of intraperitoneal chemotherapy (IP) combined with intravenous chemotherapy (IV) on the prognosis of patients with ovarian cancer. Methods PubMed, EMBASE, Cochrane Library and CNKI were searched from inception to January 1, 2023. Randomized controlled trials about IP and IV in the treatment of ovarian cancer were collected. The study group was treated with IP combined with IV, and the control group was treated with IV alone. The progression-free survival (PFS), overall survival (OS) and the incidence of adverse reactions were analyzed. Results A total of seven studies involving 4 057 patients were included. The results of meta-analysis showed that the PFS of the study group was significantly longer than that of the control group, and the difference was statistically significant (HR=0. 86, 95%CI:0. 77-0. 95, P=0. 004) . The results of subgroup analysis showed that there was no significant difference in PFS between the two groups (HR=0. 85, 95%CI:0. 68-1. 05, P=0. 12) . The OS of the study group was longer than that of the control group, and the difference was statistically significant (HR=0. 89, 95%CI:0. 79-1. 00, P=0. 04) . The incidence of adverse reactions (≥grade 3) in the study group was lower than that in the control group, and the difference was statistically significant (HR=1. 22, 95%CI:1. 09-1. 37, P=0. 000 8) . The results of subgroup analysis showed that there were significant differences in the incidence of gastrointestinal adverse reactions, infection and thrombosis between the two groups (P<0. 05) . However, there was no significant difference in the incidence of hematological toxicity and neurotoxicity (P>0. 05) . Conclusion IP combined with IV can prolong the survival time of patients with ovarian cancer and delay the recurrence time, but it is necessary to be alert to the occurrence of severe adverse reactions. [ABSTRACT FROM AUTHOR]