Purpose: In order to verify the differences of effectiveness and safety between SAHs and Montelukast, and to find out potential uncared-for problems, we performed a systematic review and Meta-analysis to proceed a qualitative describe and quantitative assessment. Methods: We searched the databases of Pubmed, the Cochrane Library, Nature and Science as well as Wanfang data and CNKI from 2000 to March 2016, using key words "Montelukast SAH" or " H1antihistamine Montelukast", or "Loratadine Montelukast", or " Desloratadine Montelukast", or " Levocetirizine Montelukast", or "Cetirizen Montelukast", or "Fexofenadine Montelukast". And also we included studies through relevant citations in related literature. Meta-analysis and bias of risk were performed. We analyzed Heterogeneity and publish bias as well. Result: Montelukast seems more effective in nighttime symptoms compare with SAHs (P = 0.008, MD = 0.04, 95% CI: - 0.08, 0.01). No significant difference was found between Montelukast and SAHs in CSS (P = 0.10, MD = 0.03, 95% CI: -0.01, 0.07). Montelukast and SAHs combined therapy was more effective than Montelukast DNSS (P = 0.0006, MD = 0.15, 95% CI: 0.07, 0.24) but not in CSS (P = 0.04, MD = 0.08, 95% CI: 0.00, 0.15; Bonferroni correction a = 0.017). Conclusion: Montelukast has a significant influence in improving patients' nasal symptoms quality of live but is not as effective as SAHs, and may have a slight advantage over SAHs in relieving nighttime symptoms significantly. Combined therapy is more effective in improving patients' day time symptom than Montelukast. Probably, patients might have a lower asthenia incidence rate when using Montelukas. (C) 2016 Elsevier Masson SAS. All rights reserved.