Anal sinusitis is an acute or chronic inflammation of the anal sinus, anal flap, and anal glands. There are many traditional Chinese medicine (TCM) therapies for anal sinusitis, and most of them can achieve satisfactory results. Retention enema is one effective treatment for anal sinusitis. Although a number of studies have shown the effectiveness of retention enema with TCM in treating anal sinusitis, the results are inconsistent. Therefore, a meta-analysis was carried out in this study to evaluate the efficacy and safety of retention enema with TCM in the treatment of anal sinusitis. Randomized controlled trials on TCM retention enema for treating anal sinusitis were retrieved from PubMed, EMBASE, The Cochrane Library, CNKI, WanFang databases and VIP databases. The search time limit was from the database establishment to November 15, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 2.0). The meta-analysis was conducted by RevMan 5.3. The results of this study will be published in a peer-reviewed publication. This systematic review and meta-analysis will provide evidence for the efficacy and safety of TCM retention enema in the treatment of anal sinusitis.