Objective: To compare the efficacy of femtosecond laser-assisted phacoemulsification (FLACS) and conventional coaxial phacoemulsification (CPS) in the treatment of cataract. Methods: PubMed, PMC and other databases were searched for controlled trials comparing FLACS and conventional CPS in the treatment of cataract. According to the title, key words and abstract, appropriate literatures were selected for inclusion and reasonable exclusion. After reading the literature, the methodological quality of the included studies was evaluated using the Cochrane bias risk assessment tool. Meta-analysis was performed using RevMan5.4.1 software to evaluate the efficacy of FLACS and conventional CPS in the treatment of cataract. Results: Excluding duplicate articles, a total of 128 articles were retrieved, including 2054 patients in the experimental group and 2592 patients in the control group. There were no significant differences in age, gender and disease severity between the two groups. The results of meta-analysis showed that the efficacy of FLACS was significantly better than that of CPS in the treatment of cataract. Although the absolute phacoemulsification time (APT) (95%CI (3.99, 18.58), P=0.002) of FLACS was slightly longer than that of CPS, it significantly reduced endothelial cell loss (ECL) (95%CI (-4.41, -0.89), P=0.003), corrected distance visual acuity (CDVA) (95%CI (-0.25, -0.03), P=0.01) and cumulative dissipated energy (CDE) (95%CI (-3.41, -0.67), P=0.004). Thus, the visual quality of the patients was improved. Conclusion: In conclusion, FLACS has a greater advantage in reducing ECL, CDVA and CDE compared with CPS. It is believed that FLACS will be accepted by more patients with the concept of precision medicine, the improvement of patients' requirements for visual quality, and the more personalized surgical plan by doctors.