A systematic review of literature sourced from PubMed, EMBASE, ISI, Web of Science, Scopus, CENTRAL, Google Scholar and Trip database to 1 October 2015, about the safety and efficacy of chloral hydrate (CH) by meta-analysis of randomised controlled trials (RCTs) was performed; 104 articles were included and a total of 24,265 sedation episodes were found in children under one month to 18 years old. The meta-analysis showed CH had a higher odd ratios (2.95, 95% CI 1.09 to 7.99) for successful sedation comparing other sedatives. Common adverse events (AE) were not serious (e.g. paradoxical reaction or transient vomiting) and no intervention was required. Severe AE including two deaths, were related to comorbidity, overdose or aspiration. The authors concluded that based on existing literature, CH is an effective alternative to general anaesthesia for procedural sedation, when used in a hospital setting with appropriate monitoring and intervention.