Objective Through the systemic evaluation of the efficacy of clarithromycin in the treatment of sinusitis after radiotherapy for nasopharyngeal carcinoma, to clarify the clinical application value of the drug and provide relevant evidence-based medicine.Methods The english database search (PubMed, Embase, the Cochrane library) and Chinese database (CNKI, CBM, VIP) were retrieved from the establishment of each database to October 24, 2020. According to the criteria of whether it is sinusitis after radiotherapy for nasopharyngeal carcinoma, and whether it is treated with clarithromycin, the relevant clinical research data were obtained after literature screening and retrieval. A meta-analysis study was performed using Review Manager 5.4.Results The reporting studies of seven articles were included in the analysis with a total number of 516 patients. And the results showed that clarithromycin had a statistically significant effect on sinusitis after radiotherapy for nasopharyngeal carcinoma[RR=1.33，95%CI(1.19，1.48)，P<0.01], and VSA score was statistically significant [MD=-2.24,95%CI(-2.51,-1.97),P<0.01]. The low sensitivity of the funnel-plot analysis suggested that the analysis results of this study are relatively stable.Conclusion Clarithromycin has obvious advantages and small adverse reactions for the treatment of sinusitis after radiotherapy for nasopharyngeal carcinoma, so the clarithromycin is preferred.