Purpose: The objective of this study was to evaluate the effect of Polymyxin B hemoperfusion (PMX-HP)on patients with sepsis. Methods: A systematic review and meta-analysis was performed using relevant articles retrievedfrom 3 databases (PubMed, Cochrane Library, EMBASE). Randomized studies from 1 January 1999to 28 February 2022 were examined to determine the clinical results of PMX-HP. A meta-analysis wascarried out using the random-effects method, meta-regression with clinical variables, and assessmentof risk of bias (ROB) tool (Cochrane ROB assessment tool). Mortality was evaluated within 60 days ofhospitalization (in-hospital death 28-day, 30-day, and 60-day mortality) and predictors associated withmortality were determined using meta-regression. Results: There were 11 randomized studies with 548 patients included in the meta-analysis. The pooledmortality was 35% (95% CI, 27%-42%, 95% CI 0.53-0.96). Further subgroup analysis was performedaccording to the duration of PMX-HP. An extension of PMX-HP treatment beyond 2 hours (pooledmortality, 43%; 95% CI, 9%-76%) compared with a 2-hour session (pooled mortality, 33%. 95% CI, 27%-38%) showed an increase in mortality rates. However, this was not statistically significant. Univariatemeta-regression showed that patient’s age, the a...