To assess the clinical effect of neuroelectrophysiological monitoring-assisted microsurgery on the protection of facial nerve function in acoustic neuroma surgery. Methods: Using PubMed, Cochrane Library, EMbase, VIP, CNKI, Wan Fang database, and Baidu Scholar, we searched for randomized controlled trials (RCT) and non-randomized controlled trials (nRCT) that studied the protective effect of neuroelectrophysiological monitoring-assisted microsurgery and simple microsurgery on facial nerve function in acoustic neuroma surgery. The studies retrieved were from January 2014 to February 2019. Meta-analysis was conducted by STATA12.0 software. Results: Fourteen trials involving 1274 patients were included. The results of meta-analysis showed that, compared to simple microsurgery, neuroelectrophysiological monitoring-assisted microsurgery demonstrated a significantly higher rate of total removal of the tumor [OR=1.952, 95% CI (1.364, 2.793), P<0.05], improved intraoperative anatomical retention rate of the facial nerve [OR=3.711, 95% CI (2.418, 5.696), P<0.05], greater efficiency of the postoperative facial nerve function retention rate [OR=4.022, 95% CI (2.597, 6.228), P<0.05], and improved postoperative facial paralysis symptoms [OR=8.785, 95% CI (4.685, 16.747), P<0.05]. Conclusion: Compared to simple microsurgery, neuroelectrophysiological monitoring-assisted microsurgery can effectively improve the rate of total tumor removal, intraoperative anatomical retention rate of the facial nerve, postoperative protective rate of nerve function, and postoperative symptoms of facial paralysis