Background Autologous fat grafting has been widely used in plastic and reconstructive surgery, but one of the main reasons for limiting its application is the high resorption rate. Platelet-rich fibrin (PRF) is a new generation of platelet concentrate that has recently been used to improve the survival rate of fat grafts. The purpose of this study was to evaluate the effect of PRF on fat grafting. Methods Animal studies in four databases (PubMed, Cochrane library, Ovid, and Wan fang database) were searched up to July 2019. A meta-analysis was performed to compare PRF + fat grafting and fat grafting alone or platelet-rich plasma (PRP) + fat grafting in animal models. Result Six studies with 83 animals (123 fat graftings) were included in our meta-analysis. The fat survival rate (mean difference (MD) 0.14, P < 0.00001) and the microvessel density (MVD) (standardized mean difference 4.20, P = 0.02) of the PRF + fat group were significantly higher than that of the fat alone group. There was no significant difference between the PRF + fat group and PRP + fat group in the fat survival rate (MD 0.05, P = 0.06). Conclusion This study found that PRF combined with fat grafting may have an effect on improving the survival rate and MVD of fat grafts. However, when comparing the effects of PRF and PRP on the fat survival rate, there is currently no clear evidence to prove the difference between them. More preclinical and clinical studies are necessary to further clarify the effect of PRF on fat grafting in humans. No Level Assigned This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .