Aims This study aimed to compare the efficacy and safety of high-power (HP) ablation to conventional power (CP) in patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation (AF). Methods and Results A systematic literature search was performed using the Medline and EMBASE databases up to February 2020 without language restrictions. Studies comparing HP (≥ 50W) with CP (≤ 40W) radiofrequency ablation (RFA) for circumferential PVI were included. The primary efficacy endpoint was the rate of freedom from AF recurrence. The first-class isolation rate, the percentage of acute pulmonary vein reconnections (PVR), RFA time, and procedure time were assessed as secondary efficacy outcomes. Safety was measured as the incidence of complications. In total, 10 eligible studies (2912 patients) were included. The rate of freedom from AF recurrence was similar between the two groups (odds ratio (OR): 1.34, 95% confidence interval (CI): 0.94－1.91; P = 0.10). The first-class isolation rate was significantly higher in the HP group (OR: 2.65, 95% CI: 1.72－4.09; P < 0.001). The HP group showed significantly less acute PVR (OR: 0.19, 95% CI: 0.07－0.49; P < 0.001). RFA time and procedural time were significantly shorter in the HP group. The percentage of pericardial tamponade was similar in both groups. Conclusions RFA with HP did not improve the rate of freedom from AF recurrence, but significantly shortened RFA time and procedure time with a significantly higher rate of first-class PVI and lower rate of acute PVR. The HP ablation strategy demonstrated a comparable safety profile to CP ablation.