Objective To investigate the efficacy and safety of antiviral therapy in chronic hepatitis B virus carriers（CHBVCs） through a systematical review by searching the databases in China and globally. Methods PubMed，Embase，the Cochrane Library，Web of Science，CNKI，Wanfang Data，VIP，and CMB were searched for randomized controlled clinical trials or cohort studies on antiviral therapy for CHBVC，with the regimens of nucleos（t）ide analogue（NA） alone，interferon-α（IFNα） alone，and NA combined with IFNα，and Stata17 was used to perform the meta-analysis. Results A total of 28 articles were included，involving 1623 CHBVCs who received antiviral therapy. As for the analysis of efficacy，serum HBsAg clearance rate was 20% （338/1421），and the HBeAg negative group had an HBsAg clearance rate as high as 52.9%，while the HBeAg positive group had a clearance of 1.5%； in the HBeAg negative group，the HBV DNA<2000 IU/mL group had an HBsAg clearance rate of 45.6%，while the HBV DNA<20 IU/mL group had an HBsAg clearance rate of 59.9%. The HBsAg seroconversion rate was 15.3%（196/946），and the HBeAg negative group had a relatively high HBsAg seroconversion rate of 38.2%，while no significant change was observed in the HBeAg positive group； in the HBeAg negative group，the HBV DNA<2000 IU/mL group had an HBsAg seroconversion rate of 34.5%，while the HBV DNA<20 IU/mL group had an HBsAg seroconversion rate of 49.4%. The serum HBeAg clearance rate was 6.6%（34/465），which gradually increased over the course of treatment and reached 8.8% at week 192. The HBeAg seroconversion rate was 8%（63/700），with the highest rate of 24% at week 96，and the combination of NA and IFNα was superior to NA alone（8.1% vs. 5.4%）. The overall serum HBV DNA clearance rate reached 70.1%（500/738）. In the analysis of safety，a statistical analysis of adverse events was performed among 494 patients in 8 articles，and the results showed that the overall incidence rate of adverse events was about 5.4%（28/494）. Conclusion Antiviral therapy has good efficacy and safety in CHBVCs，and the NA+IFNα regimen and the long-term treatment regimen have significant benefits in CHBVCs.