Objective To systematically review the efficacy of the application of team-based learning (TBL) pedagogy and traditional lecture-based learning (LBL) pedagogy in radiology education.Methods PubMed, EMbase, Web of Science, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of the application of TBL and LBL pedagogy in radiology education from inception to March 31st, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata/SE 16.0 software.Results A total of 11 RCTs involving 721 participants were included. The results of meta-analysis showed that: TBL significantly improved students’ theoretical assessment scores (SMD=1.70, 95%CI 1.05 to 2.36, P<0.001), practical assessment scores (SMD=2.00, 95%CI 1.02 to 2.98, P<0.001), preference to the curriculum design (RR=1.53, 95%CI 1.19 to 1.97, P=0.001), agreed to more effective promotion in aspects of teamwork ability (RR=2.46, 95%CI 1.69 to 3.59, P<0.001), self-directed learning ability (RR=2.41, 95%CI 1.33 to 4.39, P=0.004), and clinical practice ability (RR=2.09, 95%CI 1.46 to 3.00, P<0.001) compared to LBL pedagogical method. However, no significant difference was found in the subjective evaluation of theoretical knowledge between two pedagogies.Conclusions Current evidence shows that TBL pedagogy based on active learning and team cooperation has obvious advantages over traditional LBL mode in radiology education. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.