His methodological quality and the evidence quality of the outcome indicators of the systematic evaluation of oral Chinese herbal decoction in the treatment of primary nephrotic syndrome (PNS) were evaluated, so as to provide evidence for the treatment of primary nephrotic syndrome with oral Chinese herbal decoction. The databases of CNKI, WanFang Data, VIP, CBM, PubMed, The Cochrane Library and EMbase were searched for systematic evaluation or meta-analysis on the treatment of PNS with oral Chinese herbal decoction from the establishment of the database to November 30, 2022. Two researchers independently used AMSTAR2 scale to evaluate the methodological quality of the included study and GRADE system to evaluate the outcome indicators of the included study. A total of 11 items related to the systematic evaluation or meta-analysis of the treatment of PNS with oral Chinese herbal decoction were screened. The evaluation results of AMSTAR2 scale revealed that the 11 meta-analyses included were of extremely low quality. The GRADE system evaluation revealed that the evaluation results of five outcome indicators were intermediate (6.3%), 35 outcome indicators were low (44.3%), and 39 outcome indicators were extremely low (49.4%). Oral Chinese herbal decoction has certain clinical effect on the treatment of PNS, but there are many defects in the included systematic evaluation or meta-analysis in methodology. At the same time, the evidence quality of outcome indicators is low and more high-quality research results are urgently needed to provide evidence-based evidence support for clinical practice and provide guidance for clinical treatment of this disease.