Objective To evaluate the effectiveness and recurrence rate of Banxiaxiexin decoction in the treatment of recurrent oral ulcer(ROU). The mechanism of Banxiaxiexin decoction on ROU was studied by network pharmacology methods. Methods According to the retrieval rules of CNKI, Wan-Fang Data, TCMDB, VIP and PubMed databases, the corresponding search terms were formulated to retrieve the relevant literature, screened the literature consistent with the standards, and then Review Manager5.3 statistical software was used for Meta-analysis of the selected literature. TCMSP database was used to obtain the effective components of Banxiaxiexin decoction and predict drug targets. GeneCards and OMIM database were used to obtain ROU disease genes. R software was used to obtain intersection targets. Cytoscape 3.9.0 software was used to draw the disease-Traditional Chinese Medicine-target network diagram. The protein interaction network was constructed by using STRING online tool and Cytoscape 3.9.0 software, and GO enrichment and KEGG pathway analysis were performed by using ClueGo plug-in of Cytoscape 3.9.0 software. Results Thirteen literature were included, and the results of Meta-analysis showed that the total effective rate of Banxiaxiexin decoction in the treatment of ROU [OR=6.62, 95%CI(4.40, 9.96), P<0.000 01], which was significantly better than the control group. Recurrence rate in three months [OR=0.25, 95%CI(0.10, 0.63), P= 0.003], recurrence rate in six months [OR=0.27, 95%CI(0.13, 0.59), P=0.000 9] was markedly lower than that of the control group. There were 201 overlapping genes between the target of Banxiaxiexin decoction and ROU, whose functions involved apoptosis, intracellular signal transduction, protein phosphorylation, cell migration, programmed cell death in GO analysis. These overlapping genes were related to cancer pathway, infection-related pathway, AGE-RAGE signaling pathway, PI3K-Akt signaling pathway, MAPK signaling pathway, TNF signaling pathway, IL-17 signaling pathway in KEGG analysis. Conclusion Compared with the control group, the treatment of ROU based on Banxiaxiexin decoction has better efficacy and lower recurrence rate. Banxiaxiexin decoction treatment for ROU is a multi-target, multi-pathway complex process, and its mechanism needs more experimental data support.