Abstract： Objective To systematically evaluate the bleeding risk of patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor receptor(VEGFR)inhibitors.Methods Collected from domestic and foreign databases the clinical trials of metastatic renal cell carcinoma treated with VEGFR inhibitor monotherapy.By using the internationally commonly-used Cochrane Collaboration's Risk Assessment Tool for methodological quality,and RevMan 5.3 for meta-analysis,the incidence of bleeding risk was compared between VEGFR inhibitors(observation group)and placebo or other anti-tumor agents(control group).Results The results showed that VEGFR inhibitors caused a significantly higher incidence of bleeding risk than placebo or interferon[14.6%(258/1 769)vs.3.4%(52/1 545),RR=5.19,95%CI(3.79,7.12),P<0.000 01].Compared with mammalian target of rapamycin(mTOR)inhibitors,VEGFR inhibitors significantly reduced the risk of bleeding[17.0%(106/622)vs.(4.6%29/635),RR=0.23,95%CI(0.15,0.36),P<0.000 01].Conclusion VEGFR inhibitors for metastatic renal cell carcinoma had a risk of bleeding,but the risk of bleeding was lower than that of mTOR inhibitors.VEGFR inhibitors should be used with caution for patients with metastatic renal cell carcinoma at risk of bleeding.