Objective To evaluate the efficacy of simple plasma exchange (PE) and double plasma molecular absorption system(DPMAS) combined with half dose PE in the treatment of severe hepatitis. Methods PubMed, Embase, the Cochrane Library, CNKI and Wanfang Data were searched by computer, literatures on randomized controlled trials about PE and DPMAS+PE in the treatment of severe hepatitis were collected, Meta-analysis on clinical research conforming to the inclusion was conducted by Stata/SE 15.1 software. Results A total of 8 literatures, 819 patients were included in analysis, 394 of patients were treated with simple PE and 425 were treated with DPMAS+PE. There were no significant differences in the effect of PE as well as DPMAS+PE treatment on total bilirubin, direct bilirubin, alanine-aminotransferase(ALT), white blood cells, total protein, globulin, prothrombin activity, chlorine ion and sodium ion (all P>0.05); after treatment, hemoglobin and platelet in PE+DPMAS group were higher than those in PE group, difference was statistically significant (SMD=-0.33, 95%CI:-0.51—-0.15,P<0.001; SMD=-0.27, 95%CI:-0.45—-0.09, P=0.003, respectively); potassium ion in PE+DPMAS group was higher than that in PE group (SMD=-0.29, 95%CI:-0.49—-0.10, P=0.003). Conclusion Both PE and DPMAS+PE can effectively improve the condition of patients with severe hepatitis, PE+DPMAS can effectively reduce the amount of plasma used, and has less effect on the decrease of potassium ion, hemoglobin and platelet. Therefore, DPMAS+PE is a better choice for treating patients with severe hepatitis, especially in the case of insufficient plasma.