Objective To analysis the safety of high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids and provide references for clinical practice and prevention of complications of gynecological diseases. Methods Databases including PubMed, The Cochrane Library (Issue 2, 2016), EMbase, CBM, CNKI, and VIP were searched to collect studies concerning the complications of HIFU for uterine fibroids from March 1st 2005 to February 15th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using R software. Results A total of twenty studies involving 2 405 patients were included. The results of meta-analysis showed that complications rate of gynecological system induced by HIFU was 6.63% (95%CI 3.58% to 12.28%); among them, the incidence of vaginal bleeding was 5.82% (95%CI 3.22% to 10.53%), and the incidence of abdominal pain was 10.02% (95%CI 4.77% to 21.05%). Conclusion The current evidence shows that there is a certain amount of complications of HIFU for uterine fibroids. Due to the limited quantity and quality of included studies, the above results are needed to be validated by more studies.