Objectives To assess the efficacy and safety of Xiaoyao Powder （Carefree Powder） in the treatment of depression using the method of systematic review of evidence-based medicine.Method Data published before December 2009 were searched from MEDLINE

Cochrane library

CNKI

VIP

CBM.We included randomize-controlled trials （RCT） testing Xiaoyao Powder against placebo or antidepressants

and Xiaoyao Powder combined with antidepressants against antidepressants alone.Two researchers collected data independently.The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.017.The outcome measure index was relative risk or difference of mean value （95% confidence interval）.Results Thirty-two RCTs involving 2 253 patients were included.Involved trials published in Chinese were of low quality.In the trials of comparison between Xiaoyao Powder and placebo

only decrease of self-rating depression scale （SDS） score was not significantly different.For general clinical improvement and decrease of Hamilton rating scale for depression （HAMD） and SDS scores

Xiaoyao Powder combined with antidepressants was more effective than antidepressants alone

but the effect of Xiaoyao Powder was equal to antidepressants.No adverse effect was reported in the trials regarding Xiaoyao Powder.Conclusions Xiaoyao Powder appears to be effective for depression.However

the exact effect needs to be confirmed in well-designed large-sampled clinical trials.