Objective To systematically evaluate the clinical efficacy and safety of Moist exposed burn ointment (MEBO) in promoting wound repair and skin regeneration after anal ffstula surgery. Methods PubMed, The Cochrane Library, Embase, Web of Science, Scopus, CINAHL, CNKI, Wanfang Data, VIP and SinoMed databases were searched to collect randomized controlled trials (RCTs) of MEBO on wounds after anal ffstula surgery. The RoB 2.0 tool was adopted to assess the risk of bias, and RevMan 5.4 and R software were used for Meta-analysis. The pooled effect size and 95% prediction interval (PI) were reported for primary outcomes, and the HKSJ method was applied for robustness analysis. Results A total of 13 RCTs involving 1145 patients were included. Compared with conventional nursing or conventional dressings, MEBO could shorten the complete wound healing time (MD=-6.01, 95%CI: -7.46~-4.55, P<0.01, 95%PI: -11.69~-0.32) and improve the skin wound repair process at 14 days after surgery (MD=12.23, 95%CI: 0.50~23.95, P=0.04). In termsof pain, there was no signiffcant difference at 1 week after operation (D6-8). The pain score was decreased at 2 weeks after operation (D13-15) (MD=-0.48, 95%CI: -0.93~-0.04, P=0.03). In addition, MEBO could improve wound secretion score at about 2 weeks after surgery, relieve local inffammatory response and optimize local tissue status (SMD=-0.56, 95%CI: -0.92~-0.20, P=0.003), increase clinical effective rate (RR=1.53, 95%CI: 1.13~2.08, P<0.01), and potentially reduce the risk of complications (RR=0.18, 95%CI: 0.03~0.97, P=0.05). Egger’s test suggested no significant publication bias in primary outcomes (P=0.174). Conclusion Local application of MEBO can promote wound repair and epithelial regeneration after anal ffstula surgery, shorten healing time, and exert positive effects on relieving early and middle postoperative pain, reducing wound exudation and improving local tissue condition. No severe adverse reactions have been reported, and MEBO may lower the incidence risk of complications such as wound infection and bleeding.