Objective To systematically evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN) in patients with renal insufficiency. Methods The databases, including PubMed, Embase, Cochrane Library, EBSCO and Scopus from inception to December 2018 were searched for eligible trials evaluating the clinical efficacy of TMZ in the prevention of CIN. Meanwhile, we reviewed the relevant conference summary and websites. Meta-analysis was performed using RevMan 5.3 statistics. Results A total of 6 studies, involving 920 patients, with 456 patients in TMZ (+) group and 464 patients in TMZ (-) group were collected. Meta-analysis showed that the incidence of CIN in TMZ (+) group was significantly lower than TMZ (-) group (OR=0.31,5%CI 0.20-0.48; P<0.01). The serum creatinine (SCr) level was lower in TMZ(+) group than the other group within 3 d after procedure, but there was no statistical difference (MD=-0.22,5%CI -0.48-0.04; P=0.10). Conclusion TMZ shows a positive effect on the prevention of CIN in patients with renal insufficiency. However, more high-quality, large-sample randomized controlled trials are still needed to further confirm its efficacy.