Background: The aim of this meta-analysis was to compare levonorgestrel intrauterine system (LNG-IUS) with oral progestin for preventing the recurrence of endometrial polyps after hysteroscopic resection. Materials and Methods: Computerized literature search was performed in PubMed and several Chinese databases to screen for relevant trials. Quality assessment and meta-analysis were performed for the included trials. Results: A total of 19 randomized controlled trials were identified. Meta-analysis indicated that the LNG-IUS group was associated with lower recurrence rate of endometrial polyps than the oral progestin group (p < 0.0001), while there was no significant difference in the incidence of abnormal uterine bleeding between groups (p > 0.05). In terms of adverse effects related to progestin, the LNG-IUS group had significantly fewer adverse effects than the oral progestin group (p < 0.0001). Additionally, the LNG-IUS group had thinner endometrium and higher hemoglobin levels than the oral progestin group (p < 0.00001). Conclusion: The LNG-IUS was more effective and safer in preventing the recurrence of endometrial polyps after hysteroscopic resection than oral progestin.