Objective To systematically evaluate the efficacy and safety of intravenous immunoglobulin (IVIg) and plasma exchange (PLEX) in the treatment of myasthenia gravis (MG).Methods Cochrane Library, PubMed, Embase, China National Knowledge Internet, and Wanfang Data were systematically searched and related articles on the two methods in the treatment of MG were selected. Quality of the literature was evaluated and data were extracted independently by two researchers in accordance with the method of systematic review. Meta-analysis was performed by use of RevMan 5.2 software.Results A total of 9 studies involving 2131 patients with MG were included. The results of meta-analysis showed that there were no significant differences in the efficacy [OR=0.94, 95% CI (0.57, 1.32), P=0.79]and treatment-related adverse effects [OR=0.91, 95% CI (-0.37, 2.21), P=0.83] between IVIg and PLEX in the treatment of MG.Conclusions The efficacy and treatment-related adverse effects show no significant differences between IVIg and PLEX in the treatment of MG. Therefore, appropriate therapeutic method should be selected according to the specific conditions.