Objective To systematically review the willingness rate of the first consultation among Chinese residents at the grassroots level.Methods CNKI, WanFang Data, VIP, PubMed, Web of Science and EMbase databases were electronically searched to collect cross-sectional studies on the willingness rate of the first consultation of residents at the grassroots level from January 2006 to November 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 14.1 software.Results A total of 26 cross-sectional studies involving 36 430 subjects were included. The results of meta-analysis showed that: the willingness rate of Chinese residents for the first consultation at the grassroots level was 61.4% (95%CI 54.5% to 68.3%). The results of subgroup analysis showed that the willingness rates of the first treatment in China, the male and female residents were 65.6% and 64.9%; the urban and rural residents were 49.9% and 58.9%; <60 and≥60 years old residents were 60.5% and 71.6%; primary school and below, junior high school, high school or technical secondary school, junior college and above educational level residents were 72.8%, 68.1%, 64.2%, 52.8%; employees, residents, other types of insurance residents were 74.1%, 75.9%, 64.4%; the monthly income <3 000, 3 000-5 000, and>5 000 yuan residents were 65.8%, 65.3%, 58.5%; high level, medium, and poor health status residents were 56.8%, 52.6%, 48.8%; with and without chronic diseases residents were 61.0% and 56.9%; with and without spouse residents were 63.9%, 64.6%; with and without contracted family doctor residents were 87.1% and 62.6%; on duty, retired, and other employment status residents were 70.7%, 69.9%, 71.5%; satisfied, average, and dissatisfied for primary medical institutions residents were 77.3%, 60.7%, 49.4%.Conclusion Current evidence shows that there is still a lot of room for improvement in the level of willingness of Chinese residents for first visits. Residence, age, educational level, type of medical insurance, income level, health level, family doctors contract status, and satisfaction with primary medical institutions had an impact on residents' willingness to first treatment at primary hospitals. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.