Hematopoietic stem cell transplantation (HSCT) is a potential therapeutic procedure for patients with relapsed or refractory hematological malignancies. Oral mucositis (OM) and graft versus host disease (GvHD) are most common complication develop after HSCT. Palifermin is used to treat OM and acute GVHD (aGVHD). However there are still significant unmet clinical need for cancer patients. Therefore, we aimed to conduct a meta-analysis to assess efficacy of palifermin on OM and aGvHD after HSCT. A systematic literature search on PubMed and Cochrane was performed to identify studies evaluating effect of palifermin on OM and aGvHD after HSCT. Odds ratio (OR) and 95% confidence intervals (CI)) were calculated using the random/fixed effect model to estimate the efficacy of palifermin compared with the control group. Of 675 studies, 6 studies (n=2; RCTs and n=4; case control) met the inclusion criteria. Pooled results from the meta-analysis of RCTs found no significant effect of palifermin on OM and aGvHD when compared to control group. Similarly, subgroup analysis also failed to show significant effect of palifermin on OM and aGvHD grade (2-4 and 3-4) when compared to control group. On the other hand, results from meta-analysis of case-control studies showed significant effect of palifermin on OM (grade 1-4) [OR = 0.22; 95% CI= 0.09, 0.53; p <0.007], OM (grade 2-4) [OR = 0.24; 95% CI= 0.09,0.65; p <0.005], OM (grade 3-4) [OR= 0.22; 95% CI= 0.09,0.56; p <0.001] as compared to control group. Whereas no significant association was observed with aGvHD grades. The current meta-analysis of case-control studies found significantly reduced incidence and severity of OM and aGvHD with palifermin treatment. However, RCTs found no significant difference in OM and aGVHD grades. Further RCTs and real world studies with long term follow-up and large sample size are warranted to confirm present findings.