Abstract： Objective： To systematically evaluate the clinical efficacy of Puerarin Injection in the treatment of diabetic kidney disease （DKD）. Methods： Randomized controlled trials （RCTs） on Puerarin for DKD published between January 1， 2009 and December 31， 2024 were retrieved from databases such as China National Knowledge Infrastructure（CNKI），Wanfang Data Knowledge Service Platform （Wanfang），China Science and Technology Journal Database （VIP）， PubMed， The Excerpta Medica Database （Embase）， and China Biology Medicine disc （CBM）. After literature screening， data extraction， and quality assessment of the included studies， a Meta-analysis was performed using RevMan 5.4 software. Results：A total of 17 studies involving 1 388 patients were included. The Metaanalysis results showed that regarding primary outcome indicators，Puerarin combined with conventional treatment was superior to the control group in reducing urinary albumin excretion rate [MD=-35.70，95% CI（ -45.61，-25.80），P＜ 0.000 01]，serum creatinine [MD=-10.05，95% CI （-16.84，-3.25），P=0.004]，blood urea nitrogen [MD=-1.00， 95% CI（ -1.51，-0.48），P=0.000 1]，and 24-hour urinary protein [MD=-0.42，95% CI（ -0.75，-0.10），P=0.01]. Regarding secondary outcome indicators， Puerarin combined with conventional treatment further reduced levels of fasting blood glucose [MD=-0.56， 95% CI （-0.94， -0.18）， P=0.004] and total cholesterol [MD=-0.87， 95% CI（ -1.43，-0.32），P=0.002]. However，in reducing glycated hemoglobin [MD=-0.45，95% CI（ -1.25，0.35），P= 0.27] and triglycerides [MD=0.57，95% CI （-1.07，2.22），P=0.49]，Puerarin combined with conventional treatment did not show significant superiority over the control group. Conclusion： Puerarin， as an adjunctive therapy， can improve renal function， levels of fasting blood glucose and cholesterol in patients with DKD， with good safety. However，its effects on glycated hemoglobin and triglycerides remain inconclusive.