Compound Salvia droplet pill (CSDP) has been frequently used for patients with angina pectoris in China. However, the efficacy and safety of CSDP for unstable angina pectoris (UA) have not been systematically evaluated. The aim was to assess the efficacy and safety of CSDP for UA and provide information for current practice or future research. An extensive search was performed in Jan 2007 which included MEDLINE, EMBASE, Chinese Biomedical Database (CBM), and the Cochrane Center Controlled Trials Register. Randomized controlled trials (RCTs) about CSDP for UA were included irrespective of language. The main comparisons was CSDP plus current western drugs compared with western drugs alone. The quality of each trial was assessed according to criteria from the Cochrane Reviewers' Handbook. Statistical software (RevMan 4.2) provided by the Cochrane Collaboration was applied. Seventeen RCTs were included in this review. The quality of the trials was low. Statistical analysis of the results showed that CSDP plus western routine drugs compared with routine drugs alone had significant effect on relieving angina symptoms (P<0.00001, pooled RR=1.23, 95%CI: 1.16-1.30) and improving ECG (P<0.00001, pooled RR=1.34, 95%CI: 1.23-1.46). Some trials' data suggest that CSDP can also improve hemorheology and blood lipid level. CSDP had a significant effect for treatment of UA with few adverse events. However, the evidence is not reliable enough because of the low quality of the methodology of the included trials. To produce good evidence, high-quality clinical trials are needed.