Objective To compare the efficacy of a new drug mavacamten with conventional drugs for the treatment of hypertrophic cardiomyopathy(HCM). Methods We searched the PubMed, Cochrane Library, Embase, and Web of science databases for randomized controlled trials (RCT) on the mavacamten or conventional treatment of HCM patients using the search terms “Hypertrophic cardiomyopathy”, “Mavacamten”, “β-blockers”, “Calcium channel blockers”, “Angiotensin II receptor blocker”. The primary outcome was changes in resting left ventricular outflow tract(LVOT) gradient. Secondary outcomes were changes in left ventricular ejection fraction (LVEF), peak oxygen consumption (pVO2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). The pairwise and indirect-comparisons(network) meta-analysis used pooled weighted mean difference (WMD) and 95% confidence interval(CI). Results Eleven RCTs with 933 patients were enrolled in the pairwise meta-analysis, of which three trials were designed to evaluate the efficacy of mavacamten in patients with HCM, four trials to investigate the efficacy of ARB, three trials to evaluate the efficacy of antianginal drugs(ranolazine, trimetazidine, perhexiline), and one trial to investigate the efficacy of spironolactone. Traditional meta analysis results showed that compared with placebo, mavacamten significantly reduced the resting LVOT gradient(WMD=-33.34，95%CI:-39.13～-27.55，P＜0.001), LVEF (WMD=-3.37，95%CI：-4.83～ -1.90, P＜0.001) and NT-proBNP (WMD=-408.99, 95%CI:817.56～-0.42,P=0.05).In the indirect-comparisons meta-analysis, mavacamten significantly decrease LVOT (WMD=-34.64，95%CI:-41.90～ -27.38) and LVEF (WMD=-5.12，95%CI:-8.16～ -2.07), compared with ARB. In addition, mavacamten was superior to antianginal drugs in reducing resting LVOT gradient (WMD=-35.54，95%CI:-44.00～-27.08).Conclusion Compared with placebo or conventional drugs, mavacamten showed superiority in the reduction of resting LVOT gradient, NT-proBNP and abnormally elevated LVEF among patients with HCM