Background Post-stroke epilepsy (PSE) is quite common in clinical setting, it’s necessary to systematically evaluate the medication safety and effectiveness of Oxcarbazepine (OXC) and carbamazepine (CBZ) for the treatment of PSE. Methods We searched Medline and other databases to identify the randomized controlled trials (RCTs) comparing the OXC and CBZ for the treatment of PSE. Two authors extracted and analyzed the data independently with Revman 5.3 software. Q-test and I2 was used to test the statistical heterogeneity., Fixed or random effect models were selected according to the heterogeneity. Results Eight RCTs which include 671 patients were involved in this study. The meta-analyses result showed that the overall efficiency of OXC was significantly better than CBZ treatment (OR=4.55, 95%CI (3.04-6.81)), the overall adverse events (OR=0.27, 95%CI (0.18-0.42) and the incidence of vomit (OR=0.28, 95%CI (0.09-0.85)) of OXC was significantly less than CBZ treatment. Significant differences are not detected on the incidence of rash (OR=0.45, 95%CI (0.19-1.07)), lethargy (OR=0.49, 95%CI (0.16-1.45)), dizziness (OR=0.51, 95%CI (0.20-1.35)), between OXC and CBZ treatment. Conclusions OXC seems to be superior to CBZ in the treatment of PSE with being more effective and safer. However, more research on OXC and CBZ in the treatment of PSE is needed in the later stage due to the limitation of sample size and number of patients in this study.