This meta-analysis evaluates the effectiveness of enhanced recovery after surgery (ERAS) guidelines in improving hospital length of stay, readmission rates, complications, and mortality compared to usual surgical care. The study searched multiple databases from inception until June 2021 and included 74 randomized clinical trials involving 9076 participants from 21 countries. The results showed that ERAS guidelines were associated with a significant reduction in hospital length of stay by an average of 1.88 days (95% CI, 0.95-2.81 days) and a decreased risk of complications (RR, 0.71; 95% CI, 0.59-0.87). However, there was no significant difference in readmission rates or mortality between the ERAS and control groups. The study suggests that ERAS guidelines can improve patient outcomes but highlights the need for further research to improve implementation and compliance.This meta-analysis evaluates the effectiveness of enhanced recovery after surgery (ERAS) guidelines in improving hospital length of stay, readmission rates, complications, and mortality compared to usual surgical care. The study searched multiple databases from inception until June 2021 and included 74 randomized clinical trials involving 9076 participants from 21 countries. The results showed that ERAS guidelines were associated with a significant reduction in hospital length of stay by an average of 1.88 days (95% CI, 0.95-2.81 days) and a decreased risk of complications (RR, 0.71; 95% CI, 0.59-0.87). However, there was no significant difference in readmission rates or mortality between the ERAS and control groups. The study suggests that ERAS guidelines can improve patient outcomes but highlights the need for further research to improve implementation and compliance.