Abstract：Objective：To systematically evaluate the efficacy of Chinese medicine external treatments for patients with chronic cough. Methods： Computerized searches were conducted in databases including China National Knowledge Infrastructure（CNKI），Wanfang，China Biology Medicine disc（CBM），VIP，Cochrane Library，Embase， PubMed， and Web of Science for randomized controlled trials on Chinese medicine external treatments for chronic cough，with the search period ranging from the inception of the databases to April 2025. Two researchers independently conducted literature searches， screening， data extraction， and quality assessment. Meta-analysis was performed on the included studies using RevMan 5.3 software. Results：A total of 27 articles were included，covering 2 720 cases. The Meta-analysis results showed that the cough symptom scores in the intervention group were lower than those in the control group [MD=-1.05，95%CI（-1.45，-0.65），P＜0.000 01]. Subgroup analysis considered intervention time as a source of heterogeneity，with significant effects in the 2-week intervention group [MD=-1.29，95%CI（-1.40，-1.19）， P＜0.000 1] and the 3-week intervention group [MD=- 0.73， 95%CI（- 1.14， - 0.32）， P＜0.01]. The levels of inflammatory factors CRP [MD=-5.22， 95%CI（-7.74， -2.69）， P＜0.000 01] and TNF-α [MD=-0.15， 95%CI （-0.19，-0.11），P＜0.000 01] were lower in the intervention group than in the control group. Subgroup analysis found that the heterogeneity in CRP results was related to Chinese medicine etiology and pathogenesis，with significant effects in the composite syndrome group（MD=-10.94）and the external pathogens invading the lung group（MD=-1.36）（both P＜0.000 01）. After excluding studies in the acute phase of the disease， the heterogeneity in the internal pathogens disturbing the lung group was significantly reduced. Sensitivity analysis for TNF-α considered different disease stages as a source of heterogeneity， and after excluding studies in the acute phase of the disease， the heterogeneity was significantly reduced and the results were robust [MD=-0.15，95%CI（-0.19，-0.11），P＜0.000 01]. The effective rate was higher in the intervention group than in the control group [OR=3.94，95%CI（3.08，5.05），P＜0.000 01]， and the incidence of adverse reactions was lower in the intervention group [OR=0.22，95%CI（0.07，0.65），P＜0.01]. The quality of life was higher in the intervention group than in the control group [MD=2.01，95%CI（0.81，3.20），P＜ 0.05]. After excluding studies with differences in questionnaire dimensions，subgroup analysis found significant results in the external pathogens invading the lung group [MD=2.14，95%CI（1.52，2.77），P＜0.000 01]，but no significant difference within the internal pathogens disturbing the lung group [MD=1.97， 95%CI（- 0.64， 4.58）， P=0.14]. Conclusion： Chinese medicine external treatments have a clear efficacy in treating chronic cough， effectively alleviating cough symptoms，improving quality of life，with few adverse reactions and high safety. However，more rigorous and high-quality randomized controlled trials are still needed in the future to verify the reliability of the results.