BACKGROUND: Propranolol is widely recognized as a nonselective β-adrenergic receptor blocker known to enhance uterine activity in both pregnant and non-pregnant women. Prolonged labor and serious concerns about maternal and neonatal health prompted us to investigate medical issues. The aim of this systematic review and meta-analysis was to assess the effect of propranolol on cesarean deliveries during prolonged labor. METHODS: A systematic search was conducted in databases including PubMed, Cochrane CENTRAL, Science Direct, Google Scholar, Embase, and Web of Science from inception to 1 November 2023. We included randomized clinical trials that evaluated maternal and neonatal outcomes in patients receiving intrapartum propranolol during prolonged labor. Unadjusted risk ratios with 95% confidence intervals were calculated using a fixed-effects model. The I RESULTS: Of the 704 identified articles, six were included in the meta-analyses. There was a significant difference in cesarean deliveries between propranolol and placebo (RR 0.80, 95% confidence interval 0.59-1.09, CONCLUSION: In this meta-analysis, a notable reduction in cesarean rates was observed when propranolol was given to women in prolonged labor. The results of this meta-analysis show that the use of propranolol safely reduces the need for cesarean deliveries due to labor arrest disorders.