Objective To systematically evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in preventing contrast induced nephronpathy (CIN). Methods Randomized controlled trials using rhBNP for the prevention of CIN were retrieved from China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library between the establishment of databases and December 31, 2024. RevMan 5.3 software was used for meta-analysis. Results A total of 12 articles were included. The meta-analysis results showed that compared with the saline group, the rhBNP group had a lower incidence of CIN [relative risk (RR)=0.39], blood creatinine levels at 48 hours [(standardized mean difference (SMD)=−0.79] and 72 hours (SMD=−0.68), cystatin C levels at 48 hours (SMD=−0.44) and 72 hours (SMD=−0.72), incidence of adverse events (RR=0.53), and higher eGFR at 48 hours [mean difference (MD)=4.62] and 72 hours (MD=7.11) after angiography. Conclusion The rhBNP may reduce the incidence and adverse events of CIN, and alleviate renal function damage after angiography.