Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management, while there are different opinions on the efficacy of PDT for OLP. To comprehensively assess the efficacy of PDT in the treatment of OLP, and compare it with steroid therapy . Methods A systematic review and meta-analysis was conducted to assess the curative effect of PDT, five electronic databases were searched, including PubMed, Web of Science (SCI), the Cochrane Library, Embase, and EBSCO, up to December 1, 2019. Random or fixed effects models for pooled estimates calculation were used and the Meta package of R software was applied. Results Pooled estimates revealed that lesion size decreased by 1.53 cm 2 (95%: 0.71-2.35) after PDT, while partial response (PR) reached 0.77 (95% CI: 0.65–0.85). The visual analog scale score was decreased 3.82 (95%CI:2.80-4.85), and the Thongprasom sign score was decreased 1.33 (95%CI:0.56-2.10) after PDT. Subgroup analyses revealed that the 5-Aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with the PR was 0.87 (95%:0.80-0.91). Topical use of 5-ALA can yield better response than gargling methylene blue. In terms of VAS, the diode laser showed better clinic partial response in treatment of OLP. But on changes of lesion size, the efficacy of semiconductor laser is higher than diode laser. And the similar efficacy of PDT with topical corticosteroids was confirmed by pooled estimates of five RCT trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality in the management of OLP. Besides, PDT is as effective as topical corticosteroid in treating OLP and could be used for cases resistant to steroids or when steroids are contraindicated.