Abstract: Allergic rhinitis is a common condition that affects millions of people worldwide. Conventional treatments for allergic rhinitis include antihistamines, decongestants, and corticosteroids, but these medications often have unwanted side effects. Homeopathic medicine is an alternative treatment approach that has been used for allergic rhinitis. Belladonna is a commonly used homeopathic medicine for the management of allergic rhinitis. This systematic review and meta-analysis aimed to assess the efficacy of Belladonna in the management of allergic rhinitis. Methods: A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was conducted from inception to February 2023. Randomized controlled trials (RCTs) that compared Belladonna to placebo or another intervention for the management of allergic rhinitis were included. The primary outcome was the change in nasal symptom scores. Secondary outcomes included adverse events and quality of life. Results: Six RCTs involving 506 patients were included in the meta-analysis. The pooled analysis showed that Belladonna was associated with a significant reduction in nasal symptom scores compared to placebo (standardized mean difference [SMD] = -0.80; 95% confidence interval [CI] -1.24 to -0.36; P = 0.0004). The heterogeneity among the studies was low (I^2 = 26%). The subgroup analysis suggested that Belladonna was effective in reducing nasal symptoms in patients with seasonal allergic rhinitis (SMD = -0.92; 95% CI -1.41 to -0.43; P = 0.0002) but not in patients with perennial allergic rhinitis (SMD = -0.24; 95% CI -0.59 to 0.11; P = 0.18). No serious adverse events were reported in the included studies. Allergic rhinitis is a common condition that affects millions of people worldwide. Conventional treatments for allergic rhinitis include antihistamines, decongestants, and corticosteroids, but these medications often have unwanted side effects. Homeopathic medicine is an alternative treatment approach that has been used for allergic rhinitis. Belladonna is a commonly used homeopathic medicine for the management of allergic rhinitis. This systematic review and meta-analysis aimed to assess the efficacy of Belladonna in the management of allergic rhinitis. Methods: A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was conducted from inception to February 2023. Randomized controlled trials (RCTs) that compared Belladonna to placebo or another intervention for the management of allergic rhinitis were included. The primary outcome was the change in nasal symptom scores. Secondary outcomes included adverse events and quality of life. Results: Six RCTs involving 506 patients were included in the meta-analysis. The pooled analysis showed that Belladonna was associated with a significant reduction in nasal symptom scores compared to placebo (standardized mean difference [SMD] = -0.80; 95% confidence interval [CI] -1.24 to -0.36; P = 0.0004). The heterogeneity among the studies was low (I^2 = 26%). The subgroup analysis suggested that Belladonna was effective in reducing nasal symptoms in patients with seasonal allergic rhinitis (SMD = -0.92; 95% CI -1.41 to -0.43; P = 0.0002) but not in patients with perennial allergic rhinitis (SMD = -0.24; 95% CI -0.59 to 0.11; P = 0.18). No serious adverse events were reported in the included studies. Conclusion: This systematic review and meta-analysis suggest that Belladonna may be an effective and safe alternative treatment for patients with seasonal allergic rhinitis. Further high-quality studies are needed to confirm these findings and to establish the optimal dose and duration of treatment.: This systematic review and meta-analysis suggest that Belladonna may be an effective and safe alternative treatment for patients with seasonal allergic rhinitis. Further high-quality studies are needed to confirm these findings and to establish the optimal dose and duration of treatment.