Purpose: Although widely used, questions remain about the efficacy of MWA in the treatment of BTNs. We aimed to conduct a meta-analysis of individual patient data across all clinical trials to compare the differences in symptoms, remission, complications, and safety across the different WMA studies. Methods: We included all published RCT study and one-arm study, which were searched from PubMed, Cochrane, EMBASE, Web of Science and Ovid. Trials search last updated on Dec 1, 2020. The analysis included the number of subjects, baseline volume before nodule surgery, study type, output power used for ablation, and total duration of ablation.  Serial studies with fewer than 8 patient case reports and sample size were excluded; review articles, editorials, reviews, comments and minutes of meetings were excluded; and studies investigating substernal goiter were also excluded. We used the Cochrane Non-Random Intervention Research Bias Risk Assessment Tool (ACROBAT-NRSI) to evaluate the included literature and analyzed it using Review Manager 5.3 software. Results: Eighteen studies met the inclusion criteria (2680 patients with BTNs). The results of statistical analysis can predict lesion absorption, the VRR (%) reaches 55.9% (95% CI: 45.3-66.4%), when followed for the 3rd month. It is proved that 3 months can be used as an observation node for preliminary evaluation of curative effect. The main complications of 18 studies are summarized. Usually, the main side effects of MWA include sound changes, Horner syndrome and nodular rupture, but the most common postoperative complication of hoarseness just reached 2% (95%CI: 0.7-3.8%) and returned to normal within 3 months after surgery. According to the analysis of nodular recurrence and secondary ablation in 3 articles, the incidence of nodular regeneration was 15.8% (95%CI: 5.8-29.3%). Conclusion: US-guided percutaneous MWA was safe and effective in the treatment of BTNs, and can effectively alleviate patients' anxiety.  The optimal time for MWA postoperative absorption assessment and supplementary ablation can be advanced to the third month.