Objective To investigate the clinical efficacy of the treatment of knee osteoarthritis (KOA) with a combination of Duhuo Jisheng Decoction combined with acupuncture in the clinic. Methods A total of 7 commonly used Chinese and English databases(CNKI, China Biomedical Literature Database, Wanfang Database, VIP Database, Clinical trials.gov, PubMed, Cochrane Library) were searched,and the literature on osteoarthritis was systematically selected, with selection interval from the establishment of the library to March 2019. The relevant documents were selected according to the proposed inclusion criteria and exclusion criteria in this research, and finally included in the literature. The quality of the final literature was evaluated by three senior researchers. The evaluation criteria were based on the Cochrane Handbook for Systematic Reviews of Interventions, at the same time, Meta-analysis was performed on the standards-compliant literature using Review Manager 5.3 software. Results A total of 158 articles were retrieved, including 152 Chinese literatures and 6 foreign literatures. After screening, 7 papers were finally included. Compared with the control group, the results of the meta-analysis of clinical efficacy showed [OR=3.56, 95% CI(2.22, 5.71), P<0.000 01]; the results of meta-analysis of joint pain improvement showed [MD=-1.14, 95% CI(-1.83) , -0.46), P=0.001]; the results of the meta-analysis of WOMAC scores showed [MD=-19.26, 95% CI(-21.45,-17.07), P<0.000 01]; the results of the meta-analysis of swelling improvement showed [MD=-0.30, 95% CI(-0.40, -0.21), P=0.000 01]; the results of the meta-analysis of the adverse reaction showed [OR=0.09, 95% CI(0.03, 0.31), P=0.000 1]. Conclusion Duhuo Jisheng Decoction combined with acupuncture for knee osteoarthritis can effectively improve clinical efficiency, reduce pain, improve joint function, reduce joint swelling and have less adverse reactions, and it is worthy of promotion in clinical. However, whether the clinical effect is better than the single use of the living parasitic soup or acupuncture is insufficient evidence, more high-quality research is needed to confirm its effectiveness and safety.