Objective To evaluate the safety and efficacy of external ventricular drainage alone and external ventricular drainage combined with lumbar cerebrospinal fluid drainage for the treatment of spontaneous intraventricular hemorrhage (SIVH) by meta-analysis.Methods Literature on randomized controlled trials (RCTs) of external ventricular drainage and lumbar cerebrospinal fluid drainage for the treatment of SIVH from October 2000 to January 2015 was collected by searching PubMed/Medline, Cochrane Library, Google Scholar, Wanfang Data, CNKI, and CBM. The meta-analyses of surgical data and prognosis were performed using RevMan 5.1 software.Results Seven articles reporting RCTs were enrolled according to the literature inclusion criteria. These articles studied a total of 510 patients, including 239 patients treated with external ventricular drainage alone and 271 patients treated with external ventricular drainage and lumbar cerebrospinal fluid drainage. The results of meta-analysis showed that compared with external ventricular drainage alone, external ventricular drainage combined with lumbar cerebrospinal fluid drainage could significantly accelerate hematoma clearance (P<0.00001), improve postoperative recovery (P<0.00001), and reduce mortality (P<0.00001).Conclusions External ventricular drainage combined with lumbar cerebrospinal fluid drainage is safe and effective in the treatment of SIVH, which is superior to external ventricular drainage alone.