Abstract ： Objective ： To systematically evaluate the effect and safety of moxibustion for pain management in osteoarthritis （OA）. Methods：The databases of China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform（Wanfang）， China Science and Technology Journal Database （VIP）， Pubmed and UpToDate were searched by computer from inception to October 2024. Randomized controlled trials （RCTs） on moxibustion for pain management in OA were included. Two researchers independently screened literature， extracted data and assessed the risk of bias of included literature. RevMan5.3 software was used for analysis. Results：A total of 10 RCTs were included，with a total of 669 OA patients. The effect of moxibustion on pain management in OA patients was better than that in the control group [MD=4.06， 95%CI （2.43， 6.78）， P＜0.001]； Moxibustion significantly improved the Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC） scores in OA patients [MD= -7.80，95%CI （-8.69，-6.91），P＜0.001]；the intervention effect of moxibustion on Lysholm scores of OA patients was significantly better [MD=4.58， 95%CI （2.30， 9.11）， P＜0.001]； adverse events and adverse reactions were mild，and no serious adverse reactions were reported [RR=1.05，95%CI= （0.90，1.22）]. Conclusion：Moxibustion has a significant effect and high safety for pain management in OA.