Objective To systematically review the efficacy and safety of nicordil tablets in the treatment of coronary slow flow (CSF). Methods The databases of Cochrane Library, PubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data and CBM were retrieved from database establishment time to Nov. 2020 combined with supplement retrieving for collecting all randomized controlled trials (RCTs) about comparison between routine therapies of Western medicine combined with nicordil tablets and single routine therapies of Western medicine. The literature was strictly screened and data was extracted from included literature. The quality of included literature was reviewed according to Cochrane Handbook method. The risk of bias of included literatures was reviewed, and a Meta-analysis was conducted by using RevMan 5.3 software. Results There were totally 15 RCTs included involved 1542 patients. The results of Meta-analysis showed that nicordil tablets, compared with single routine therapies of Western medicine, improved significantly clinical effective rate in CSF patients (RR=1.43, 95%CI: 1.17~1.75, P=0.0004), reduced seizure frequency of chest pain (MD=-1.36, 95%CI: -1.67~-1.05, P<0.00001), shortened seizure time of chest pain (MD=-1.31, 95%CI: -1.61~-1.00, P<0.00001), improved coronary blood flow velocity (MD=-8.85, 95%CI: -13.50~-4.21, P=0.0002), improved high sensitivity C-reactive protein (hs-CRP), decreased inflammatory cytokines (MD=-0.92, 95%CI: -1.35~-0.50, P<0.0001), (MD=2.76, 95%CI: 0.05~5.46, P=0.05) and improved vascular endothelial function (FMD level: MD=2.78, 95%CI: 2.50~3.06, P<0.00001; basal blood flow level: MD=2.76, 95%CI: 0.05~5.46, P=0.05). There were no significant adverse reactions observed. Conclusion Nicordil tablets combined with routine therapies of Western medicine can further promote clinical efficacy with higher safety compared with single routine therapies of Western medicine.