Elevated plasma triglyceride (TG) levels are recognised as a significant risk factor for cardiovascular disease. Pemafibrate, a novel selective peroxisome proliferator-activated receptor alpha (PPAR-α) agonist, offers potential therapeutic benefits. This systematic review and meta-analysis evaluated its efficacy and safety. Multiple databases from inception to February 2024 were searched for randomised controlled trials. Eleven studies involving 11,568 patients were included. Pemafibrate significantly reduced TG levels (WMD: -125.02 mg/dL; 95% CI: -182.04 to -68.00; p <0.001), addressing a key unmet need in dyslipidaemia management by specifically targeting hypertriglyceridaemia and non-high-density lipoprotein cholesterol (non-HDL-C, WMD: -11.41 mg/dL; 95% CI: -19.77 to -3.05; p <0.001), while increasing HDL-C (WMD: 7.05 mg/dL; 95% CI: 5.78 to 8.34; p = 0.370). The drug demonstrated a favourable safety profile. Pemafibrate is an effective and well-tolerated option for dyslipidaemia management, particularly in patients with hypertriglyceridaemia. Key Words: Pemafibrate, Dyslipidaemia, Triglyceride, Efficacy, Safety.