Objective To systematically review the clinical effect and safety of cilostazol in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). Methods PubMed, the Cochrane Library, CNKI, EMBASE, CBM, VIP, and Wanfang Data were searched for controlled clinical trials of cilostazol in the treatment of patients with aSAH published up to September 2018. Two investigators were responsible for the development of inclusion criteria, screening of articles, data extraction, and quality assessment, and then RevMan 5.3 software was used to perform the meta-analysis. Results Six controlled clinical trials were included in the meta-analysis, with a total of 618 patients with aSAH. The meta-analysis showed that compared with conventional treatment, the difference was statistically significant (P<0.05).Cilostazol significantly reduced the incidence rates of symptomatic cerebral vasospasm (odds ratio[OR]=0.31,95% confidence interval[CI]:0.21-0.48), severe cerebral vasospasm (OR=0.47, 95%CI:0.31-0.69), and delayed cerebral infarction (OR=0.32,95%CI:0.20-0.52) and significantly improved the prognosis of aSAH patients (OR=2.65, 95%CI:1.66-4.21). Conclusions Cilostazol can reduce the incidence rate of cerebral vasospasm caused by aSAH and improve the prognosis of aSAH patients.