Abstract: OBJECTIVE To compare the cleaning quality of medical instruments between protein residue testing method and adenosine triphosphate（ATP） biofluorescence testing method.METHODS China National Knowledge Infrastructure, Wan Fang Database, Wei Pu Database, PubMed, Embase and Baidu Library were retrieved, the retrieval time was from the establishment of the database to January 2021, the clinical comparative studies involving the cleaning quality of surgical instruments evaluated by protein residue testing method and ATP biofluorescence testing method were screened out. The number of pieces of unqualified cleaning quality and unqualified rate of cleaning quality were the major effect indexes, the meta-analysis was performed for the included literatures by using fixed effect model.RESULTS Totally 7 pieces of research literatures met the inclusion criteria, and a total of 2 351 pieces of instruments were tested, the minimum volume was 35 pieces（routine instruments） in the experimental group, and the maximum volume was 1 000 pieces（endoscopic instruments）. The instruments that were involved in the study included routine surgical instruments, foreign instruments, da Vinci instruments, laparoscopic instruments, specialized instruments and so on. The result of Meta-analysis showed that there was no significant difference(OR=0.93,95%CI（0.75-1.15）.CONCLUSION Judging from the data, the testing effects of the protein residue testing method and the ATP biofluorescence testing method are basically the same in evaluation of the cleaning quality of the instruments, however, the result of ATP biofluorescence testing method tends to be affected by interferons, proteins have strong adhesion, cleaning is difficult, and the protein residue testing is not interfered by other factors, above all, the protein residue testing method can be served as a preferred and ideal method for evaluation of cleaning quality of the instruments but is not suitable for daily surveillance due to high cost.