Objective To compare the efficacy and safety of manidipine and amlodipine in hypertension treatment.Methods The databases of PubMed, EMbase, Cochrane Controlled Trials Register, CNKI, CBM and WanFang Database were retrieved with computer from database establish time to Feb. 28, 2014. The data was screened, extracted and reviewed by 2 researchers independently according to inclusion and exclusion criteria, and after cross-checking, was given a Meta-analysis by using RevMan 5.2 software.Results There were totally 10 RCT included involving 1625 cases, and the results of Meta-analysis showed that there was no statistical difference between manidipine and amlodipine in sitting systolic blood pressure (MD=-0.81, 95%CI: -1.88~0.26), sitting diastolic blood pressure (MD=-0.31, 95%CI: -0.96~0.34) and number of patients needed to increase drug dose (RR=1.08, 95%CI: 0.97~1.20). Manidipine was significantly superior to amlodipine in the total incidence of adverse reactions (RR=0.73, 95%CI: 0.58~0.90) and edema incidence (RR=0.35, 95%CI: 0.23~0.53). Manidipine could mildly reduce heart rate (WMD=-0.21, 95%CI: -0.40~-0.02) compared with amlodipine.Conclusion The current evidence shows that manidipine and amlodipine are similar to each other in reducing sitting systolic blood pressure and sitting diastolic blood pressure, and manidipine has higher tolerance. The total incidence of adverse reactions and edema incidence induced by manidipine are significantly lower than those induced by amlodipine. More well-designed large-scale clinical studies are required for further verifying the results.