Background: Cytokine-induced killer cells have been used as an adjuvant treatment for hepatocellular carcinoma with curative treatment. However, the outcomes remain controversial. Aim: We conducted this meta-analysis to assess the safety and efficacy of cytokine-induced killer cells. Methods: Randomized controlled trials on cytokine-induced killer cells for hepatocellular carcinoma after curative treatments were identified by electronic searches. A meta-analysis was carried out to examine disease-free survival, overall survival rate and adverse effect. Results: Six randomized controlled trials with 844 patients (85.9% with hepatitis B or C) were included. Our meta-analysis showed that cytokine-induced killer cells can not only improve the 1-year (RR = 1.23, P < 0.001), 2-year (RR = 1.37, P < 0.001) and 3-year (RR = 1.35, P = 0.004) disease-free survival, but also improve the 1-year (RR = 1.08, P = 0.001), 2-year (RR = 1.14, P < 0.001) and 3-year (RR = 1.15, P = 0.02) overall survival. However, it failed to affect the 4-year and 5-year disease-free survival and overall survival (P > 0.05). At the same time, cytokine-induced killer cells treatment was proved to be a safe strategy with the comparable adverse events comparing to the control group (P = 0.39). Conclusions: This review provides the best available evidence that adjuvant cytokine-induced killer cells treatment can be safely used to improve the early disease-free survival and survival of hepatitis B or C related hepatocellular carcinoma. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.