Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 53 12 2024 12 08 2683 2693 Shabnam Khatami 1. Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2. Traditional Persian Medicine and Complementary Medicine (PerCoMed) Student Association, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Rahimzade Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Narges Lavari 1. Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2. The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran Taha Jadidi Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran Mohammad Sadegh Adel-Mehraban 1. Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2. Traditional Persian Medicine and Complementary Medicine (PerCoMed) Student Association, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran 2023 12 23 2024 05 24 Background: Phlebotomy has been used as a non-pharmacological treatment for different types of diseases, regarding the philosophy of humors in traditional medicines, such as Persian Medicine. However, according to the narrow-approved indications for phlebotomy in Western Medicine, we aimed to systematically summarize high-level of evidence on safety and efficacy of phlebotomy in treatment of human diseases. Methods: In this umbrella review, to identify meta-analysis studies of clinical trials on phlebotomy, four electronic databases, including PubMed, web of science, Scopus, and Cochran library were searched until Jun 18, 2022 with relevant keywords for ‘phlebotomy’ and ‘meta-analysis’ according to PRISMA guidelines and PICO questions. After excluding irrelevant studies, data on subject characteristics, method of intervention, and adverse events were extracted. To evaluate the quality of the methodology of the systematic reviews, AMSTAR2 scale was utilized. Results: From 327 identified studies, 7 full texts met the inclusion criteria, consisting of 56 clinical trials on 5648 subjects. These meta-analysis studies reported effects of phlebotomy on hypertension, acute gouty arthritis, skin disease (chronic urticaria and porphyria), and liver diseases (non-alcoholic fatty liver disease, chronic hepatitis C, and liver surgery). Our results showed significant improvements in different outcomes, while the most common adverse event was hematoma. Conclusion: The level of evidence on the efficacy and safety of phlebotomy in some specific health conditions was substantial; however, to investigate the efficacy and safety of phlebotomy in management of other health problems more clinical studies with high sample sizes are needed. https://ijph.tums.ac.ir/index.php/ijph/article/view/34085 https://ijph.tums.ac.ir/index.php/ijph/article/download/34085/8414