Abstract: Objective: To analyze the effect of bisphosphonates on the overall survival (OS) of prostate cancer patients, and to provide a theoretical basis for improving the prognosis of prostate cancer with bisphosphonates. Methods: A computerized and manual search of the China Knowledge Network database, Wanfang database, VIP database, Web of Science, PubMed, Embase, and Cochrane Library was used with a search deadline of January 2024, and articles were searched for all published randomized controlled trials on the adjuvant treatment of prostate cancer with bisphosphonates. The primary observables included patient OS, Hazard atio (HR) and its 95% confidence interval (95% CI), and the secondary observables were the incidence of adverse events such as bone pain and skeletal related events (SREs) due to bone metastases. Meta-analysis was performed using the Revman and Stata software. Results: A total of 10 randomized controlled trials were included. Meta-analysis showed that the OS results between the bisphosphonate-adjuvant therapy group and the placebo group were negative (HR=-0.07, 95% CI: -0.21 to 0.07, P=0.331); there was no significant change in the incidence of SREs (OR=0.88, 95% CI: 0.69 to 1.13, Z=-0.993, P＞0.05). The differences were not statistically significant. Conclusion: Bisphosphonates can not slow the disease progression and prolong the survival in prostate cancer patients, nor can they reduce the incidence of adverse events such as SREs due to bone metastases.