To systematical assess the impact of different embryo transfer mediums on the outcomes of in vitro fertilization-embryo transfer (IVF-ET).  Methods: Computer initial inspection combined with manual retrieval method was used to systematically retrieve the databases from built up to April 2020, such as PubMed, Embase, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfangdata, etc. Two researchers independently conducted literature screening, data extraction and quality evaluation of the literature based on the inclusion and exclusion criteria. RevMan5.3 software was used for meta-analysis.  Results： A total of 21 studies involving 10854 women after IVF-ET were included. The results showed that there was no significant difference in the rates of miscarriage, delivery, and live birth, and the neonatal birth weight between the women used embryo transfer mediums with hyaluronic acid-rich and the women used embryo transfer mediums without hyaluronic acid (P>0.05). The embryo transfer mediums with hyaluronic acidrich could significantly increase the clinical pregnancy rate, planting rate, and multiple pregnancy rate, and could decrease ectopic pregnancy rate (P<0.05). Subgroup analysis was performed by different embryo types, the embryo transfer mediums with hyaluronic acid-rich could significantly increase the clinical pregnancy rate and planting rate of fresh cleavage stage embryos, and could also increase the planting rate of freeze-thaw cleavage stage embryos, while the effect was not significant for blastocysts. Conclusion: The embryo transfer mediums with hyaluronic acid-rich can significantly improve the clinical pregnancy rate, the implantation rate, the multiple pregnancy rate, reduce the rate of ectopic pregnancy, in particular, can improve the pregnancy outcomes of fresh cycle cleavage stage embryos, which will not increase the miscarriage rate, and will not affect the live birth rate and the neonatal birth weight.