Objective To systematically review the efficacy and safety of fast- track surgery( FTS) in perioperative nursing for biliary calculi surgery. Methods Online databases of Pub Med,Cochrane Library,CBM,CNKI,VIP,and Wanfang Data were comprehensively searched for relevant randomized controlled trials( RCTs). Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5. 3. Results A total of 11 RCTs with 1455 patients were included( 738 cases in FTS group and 717 cases in control group). The results of meta- analysis showed that FTS significantly reduced the length of postoperative hospital stay( MD =- 4. 10,95% CI:- 5. 68 to- 2. 52,P < 0. 000 01) and hospital costs( MD =- 0. 47,95% CI:- 0. 60 to- 0. 34,P < 0. 000 01); meanwhile,FTS shortened the time to gastrointestinal recovery( SMD =- 2. 05,95% CI:- 2. 84 to- 1. 27,P < 0. 000 01),as well as the time to first defecation( SMD =- 1. 27,95% CI:- 2. 08 to- 0. 46,P < 0. 000 01). As for safety,FTS significantly reduced the total complications of choledocholithiasis( RR = 0. 53,95% CI: 0. 43- 0. 65,P < 0. 000 01) and hepatolithiasis( RR = 0. 52,95% CI: 0. 35- 0. 77,P = 0. 001). Conclusion FTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay,enhance gastrointestinal recovery,shorten the time to first defecation,and reduce total complications.