This study aimed to evaluate the effectiveness of hypertonic saline (HS) in treating Chinese mainland populations with high intracranial pressure (HIP). The PubMed, Medline, Cochrane Library, Elsevier, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang databases were searched for all randomized controlled trials of HS used to treat Chinese mainland populations with HIP for inclusion in the meta-analysis. The mean difference (MD) and 95% confidence intervals (95% CI) were then calculated. A total of eight randomized controlled trials that studied a total of 567 cases were included. The results showed that compared with the control groups, the MD values of intracranial pressure in the HS groups 1 and 3 hours after administering the medication were 0.00 (95% CI: -0.30-0.30) and -0.23 (95% CI: -0.73-0.26), respectively, and no significant difference was apparent; the MD values of mean arterial pressure and mean venous pressure 1 and 3 hours after administering the medication also showed no significant difference. HS had the same effectiveness in lowering intracranial pressure and changing the hemodynamic features as other treatment options.