Objective To assess the relationship between androgen replacement therapy (ART) and prostate growth. Methods A literature review was performed on all published randomized controlled trials (RCT) of androgen treatment on hypogonadism and the effects of ART on Prostate growth were investigated via meta-analysis. The search included three databases: PUBMED, EMBASE, and the Cochrane Controlled Trials Register. Results A total of 9 RCTs were used in the analysis and each ART should be given 12 months or more. ART were given by three different administration methods (Injection, Transdermal and Oral). The presence of publication bias was evaluated using a funnel plot. Compared with that of placebo, after ART therapy about 12-36 months, no significant changes were found in the PSA level (Injection P =0.42; Transdermal P =0.51; Oral P =0.57); the prostate volume (Injection P =0.35; Transdermal P =0.59; Oral P =0.47); the IPSS (Injection P =0.34; Transdermal P =0.32; Oral P =0.97) and the maximum flow rate (Injection P=0.11; Transdermal P=0.6). Conclusion ART can not increase the risk of prostate growth.