ObjectiveTo evaluate the clinical efficacy of polidocanol foam sclerotherapy and to establish a reliable evidence base for its application in the treatment of hemorrhoids. MethodsA systematic literature search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP, and the Chinese Medical Journal Full-text Database for randomized controlled trials published from January 1, 2000 to December 1, 2024. Included patients were assigned to either an intervention group group (treated with polidocanol foam sclerotherapy) or a control group (receiving other interventions). Data from the included studies were pooled and analyzed using a meta-analysis model in Review Manager (RevMan) software, version 5.4. The primary outcomes were the clinical cure rate, postoperative recurrence rate, and incidence of postoperative bleeding. The secondary outcomes were the pain visual analogue scale (VAS) score and the incidence of severe postoperative pain. ResultsA total of 12 RCTs involving 1 380 patients with hemorrhoids were included. The pooled results demonstrated that, compared to the control group, the intervention group showed a significantly higher clinical cure rate [RR(95%CI)=1.36(1.26, 1.47)], as well as lower postoperative recurrence rate [RR(95%CI)=0.43 (0.29, 0.65)] and postoperative bleeding rate [RR(95%CI)=0.75(0.60, 0.93)]. However, there were no statistically significant differences between the groups in terms of postoperative pain VAS score [WMD(95%CI) =–0.53(–1.15, 0.09)] or the incidence of severe postoperative pain [RR(95%CI)=0.81(0.34, 1.94)]. ConclusionsPolidocanol foam sclerotherapy demonstrates superior clinical efficacy in terms of clinical cure rate, postoperative recurrence rate, and postoperative bleeding rate, confirming its effectiveness as a treatment for hemorrhoids.