Objective To evaluate the impact of application of electronic monitoring system (EMS) on hand hygiene (HH) compliance of health care workers (HCWs). Methods "Health care workers", "electronic system", and "hand hygiene" were used as key words, Ovid, Web of Science, PubMed, Cochrane, CINAHL, clinicaltrials.gov, China National Knowledge Infrastructure(CNKI), and Wangfang database were searched, effect and acceptability of EMS on HH compliance of HCWs were analyzed. Results 2 736 literatures were retrieved and 13 were included, 11 results showed that application of EMS could improve HH compliance, of which 9 studies detected an increase in the compliance rate ranging from 10% to 45%, 2 studies showed that the frequency of HH increased by 16.28 times and consumption of hand sanitizer increased by 2.215 liters respectively; the other study showed that the compliance rate decreased by 3.6%, and the compliance rate of one study basically did not change. The main reasons for HCWs' resistance to electronic system are infringement of privacy, impact on health and device defects. Conclusion Application of electronic system can improve the HH compliance of HCWs, but the potential impact of electronic system should be considered, in the future, effective implementation methods should be explored to correct the defects of electronic system and play a role to a greater extent.