Objective To evaluate the efficacy and safety of cold snare polypectomy (CSP) versus hot snare polypectomy (HSP) for resecting small colorectal polyps, and conduct a Meta-analysis.Methods 6 databases including PubMed, Embase, Cochrane Librabry, CNKI, Wanfang data and VIP were searched, and prospective randomized controlled trials (RCT) about CSP vs HSP for resecting colorectal polyps were enrolled. RevMan 5.3 was used for Meta-analysis. Outcomes reviewed include polyp resection rate, retrieval rate, postoperative complications, and procedure time.Results 20 RCTs including 4 103 patients with 6 890 polyps were reviewed in the study. Among of them, 3 452 polyps in CSP and 3 438 polyps in HSP, respectively. Complete resection and en bloc resection rate using CSP were similar to HSP (RR＾ = 1.00, 95%CI: 0.98 ~ 1.01, P = 0.596; RR＾ = 0.98, 95%CI: 0.95 ~ 1.01, P = 0.222). There was no significant difference in the polyp retrieval rate between CSP and HSP (RR＾ = 1.00, 95%CI: 0.99~1.01, P = 0.824). Postoperative complications (intraoperative bleeding, delayed bleeding and perforation): the risk of intraoperative bleeding in CSP is higher than that of HSP (RR＾ = 1.66, 95%CI: 1.24 ~ 2.24, P = 0.001), and the risk of delayed bleeding in CSP is lower than HSP (RR＾ = 0.31, 95%CI: 0.16 ~ 0.63, P = 0.001), while the incidence of perforation was not significant (RR＾ = 0.33, 95%CI: 0.09 ~ 1.22, P = 0.097). The total operation time and polypectomy time in CSP were shorter than those in HSP (MD = -7.15, 95%CI: -8.25 ~ -6.06, P = 0.000; MD = -1.86, 95%CI: -2.85~-0.86, P = 0.000).Conclusion The curative effect of CSP for resecting small colorectal polyps is equivalent to that of HSP, but it can reduce the incidence of delayed bleeding and shorten the operation time. We recommend CSP for resecting small colorectal polyps.