Abstract: AIM: To provide evidence for the clinic administration of amiodarone and propafenone by investigating the efficacy and safety of amiodarone vs. propafenone for maintenance of atrial fibrillation. METHODS: The Cochrane Library (Issue 4, 2008), PubMed, EMBASE and Chinese Biomedical Database were searched. The studies comparing the efficacy and safety of amiodarone vs. propafenone for the maintenance of atrial fibrillation published between January 2000 and November 2008 were included. Meta-analysis was performed using RevMan v. 5.0 software. RESULTS: Four randomized controlled trials (RCT) were identified in the efficacy of amiodarone vs. propafenone for the maintenance of atrial fibrillation. There were 221 and 204 cases, respectively, of amiodarone or propafenone and the pooled odds ratio (OR) values and 95% CI were, respectively, 0.65 (0.43-0.97, P<0.05). Three RCTs were identified in safety of amiodarone vs. propafenone for maintenance of atrial fibrillation. The cases of amiodarone and propafenone were 168 and 158, respectively, and the pooled OR values and 95% CI were, respectively, 3.79 (1.83-7.88, P<0.05). CONCLUSION: Amiodarone is superior to propafenone in maintaining sinus rhythm in patients with atrial fibrillation but propafenone is a safer option.