Objective To systematically evaluate the efficacy and safety of warfarin in preventing longterm catheter indwelling (TCC) dysfunction in hemodialysis patients. Methods Databases of Medline, Embase, Cochrane library, and Wanfang were searched with the keyword warfarin for the randomized controlled trials of longterm catheter indwelling dysfunction in hemodialysis patients. Quality evaluation was assessed by Cochrane quality evaluation standards and metaanalysis by using RevMan 5.3 was performed.Results Eight studies were included. Metaanalysis showed that the incidence of longterm catheter  indwelling dysfunction in warfarin patients was lower than that in the aspirin and the heparin control group ［RR=0.57, 95% CI(0.38, 0.86), P=0.007］, and the urea clearance index of the warfarin group was significantly higher than that of the aspirin group and the heparin control group ［MD=0.13, 95% CI (0.06, 0.20), P=0.0005］.Compared with the aspirin group and the heparin control group, the bleeding event in the warfarin group was significant higher ［RR=2.74, 95% CI (1.40, 5.34), P=0.003］, and there was no significant difference in catheterrelated infection events between the warfarin group and the aspirin group, the heparin control group ［RR=0.62, 95% CI (0.31, 1.23), P=0.17］.ConclusionWarfarin is more effective than aspirin and heparin in preventing dysfunction of TCC in dialysis patients and improving hemodialysis adequacy. Besides, bleeding events caused by warfarin should also be paid enough attention.