OBJECTIVE A meta analysis to compare efficacy and safety of bicompartmental knee arthroplasty (BKA) and Total knee arthroplasty (TKA) in patients with bicompartmental knee osteoarthritis (OA). METHOD Electronic databases included PubMed, Embase, web of science and the Cochrane Library up to the end of July 2017 were searched. High quality randomized controlled trials(RCTs) and prospective clinical controlled trials were selected based on inclusion criteria. RevMan 5.3 were used for the meta-analysis. RESULTS Five studies containing 261 patients meet the inclusion criteria. Knee Society score (KSS)-Knee Score,KSS-Function Score, and flexion range of the knee in BKA group is greater than those in TKA group (P = 0.03,P < 0.0001,P = 0.0008 respectively); Hip-Knee-Ankle (HKA) angle in BKA group is smaller than TKA group (P < 0.00001); more postoperative complications are observed in BKA group (P = 0.007); no significant difference was found in proportion of revision between the two groups (p = 0.11). CONCLUSION Compared to TKA, BKA can bring better knee function and life quality to patients with bicompartmental knee OA. Though BKA may cause more postoperative complications, it can be an alternative treatment of TKA for patients with bicompartmental knee OA.