Background <p>Pelvic inflammatory disease (PID) is a group of female upper genital tract infectious diseases. The efficacy of combining Chinese patent medicine with antibiotics in treating this condition is well-established. Our objective is to conduct a Bayesian network meta-analysis (NMA) to compare the efficacy and security of different oral Chinese patent medicines combined with antibiotics for PID.</p> Methods <p>Randomized controlled trials (RCTs) reporting oral Chinese patent medicine combined with antibiotics for PID were included by 7 databases from the inception of the databases to December 2024. The Literature that satisfied the inclusion criteria underwent screening, followed by an evaluation of the quality and risk of bias of the studies that were included, in accordance with the Cochrane 5.1 manual and RevMan 5.4. Subsequently, network meta-analysis was conducted using Stata 16.0 and R software.</p> Results <p>There were 73 RCTs included to evaluate the efficacy of 11 Chinese patent medicines combined with antibiotics. Kangfuyan Capsule (KFY) + antibiotics (SUCRA = 87.92%) showed the best efficacy in reducing the VAS (visual analogue scale) score. Jinying Capsule (JY) + antibiotics (SUCRA = 74.29%) showed the shortest time to relieve abdominal pain. Fuyanshu Capsule (FYS) + antibiotics showed the lowest recurrence rate (SUCRA = 99.18%) and were the most effective in reducing the level of C-reactive protein (SUCRA = 93.19%). Fuyankang tablet (FYK) + antibiotics (SUCRA = 91.15%) demonstrated highest security.</p> Conclusion <p>The efficacy of Chinese patent medicine combined with antibiotics in the treatment of PID is better than that of antibiotics alone. Different Chinese patent medicines have their own advantages in improving abdominal pain symptoms, reducing recurrence rate and inflammatory factors levels. Clinically, these drugs can be objectively selected based on the results of the study.</p>