Objective To evaluate the effectiveness of acupotomy in the treatment of ankylosing spondylitis (AS) by systematic review and Meta-analysis. Methods The randomized controlled clinical trials (RCT) of acupotomy for AS published from the establishment of the databases to May 2021 was retrieved from databases including China National Knowledge Infrastructure, Wanfang data, VIP, Chinese biomedical database, PubMed, EMBASE, Cochrane Library. After literature screening and data extraction,we conducted Meta analysis with RevMan 5.3 software. Results Eighteen papers were included, with a total sample size of 1 252 cases. The analysis results showed that the effectiveness of acupotomy group for AS with limitation of motion improved Compared with the control group in the following 9 aspects: the total effective rate [OR=6.80, 95%CI(4.29, 10.77), P<0.000 01], BASDAI score [MD=-1.06, 95%CI(-1.49, -0.63), P<0.000 01], BASFI score[MD=-0.92, 95%CI(-1.27, -0.56), P<0.000 01], Schober test[MD=1.20, 95%CI(0.70, 1.70), P<0.000 1], morning stiffness time[MD=-18.05, 95%CI (-20.78, -15.31), P<0.000 1], thoracic expansion[MD=1.20, 95%CI (1.07, 1.34), P<0.000 1], finger-floor distance{less than 2 years group [MD=-3.81, 95%CI (-5.39, -2.23), P<0.000 01], over 2 years group [MD=-11.12, 95%CI(- 13.22, -9.01), P<0.000 01]}, occiput to wall distance[MD=-1.79, 95%CI(-2.63, -0.95), P<0.000 1], mandible to sternum distance[MD=-1.56, 95%CI(-2.08, -1.04), P<0.000 01]. The difference was statistically significant. Conclusion Among the above 9 indicators related to activity limitation, acupotomy treatment has a clinical significance in the treatment of AS with limitation of motion, but its needs more high-quality RCT for further verification.