Objective To assess the effect of high flux hemodialysis (HFHD) on the clinical prognosis of maintenance hemodialysis (MHD) patients by the metaanalysis. Methods Published studies on the comparisons of HFHD and low-flux hemodialysis (LFHD) of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were retrieved, strictly evaluated by the methodological quality, and analyzed by the mata-synthesis. The effects of HFHD on the survival rate, cardiovascular mortality, and causes of mortality of MHD patients were systematically evaluated. Results A total of 8 studies (3 RCTs and 5 CCTs) were included and 5 015 patients were selected after being analyzed by the mata-synthesis. Results of meta-analysis showed that the difference of mortality of the HFHD group and LFHD group was not statistically significant (RR=0.85, 95%CI：0.71-1.01, P=0.06). Three RCTs showed that HFHD significantly reduced the cardiovascular mortality (RR=0.83, 95%CI：0.71-0.98, P=0.03). Two RCTs that used the same unit for describing the clearance of β2-microglobulin (β2-MG) indicated that HFHD had a better clearance rate of β2-MG (MD=-10.89, 95%CI: -14.89-6.97, P<0.000 1). Conclusion HFHD can improve the clearance rate of β2-MG and reduce the cardiovascular mortality but can not reduce the mortality of MHD patients. HFHD may have good long-term effect for MHD patients with low serum albumin or diabetic nephropathy.