Background: To systematically review the relevant literature evaluating the therapeutic efficacy of upfront docetaxel (Doc) or abiraterone (Abi) plus androgen deprivation therapy (ADT) on oncological outcome in patients with CNPC. An attempt to identify subgroups of patients who will benefit most either from Doc or Abi plus ADT and further compare the efficacy and safety between these two combination therapies. Methods: A comprehensive search of the PubMed/Medline, Embase databases, ICTRP, Clinical Trial and Cochrane Central Register of Controlled Trials to July 2017 was performed. Results: Six studies involving 6480 patients were included in this meta-analysis, consisting of over sixty percent (4462/6480) of patients with metastatic CNPC (mCNPC, M1), and 31.1% (2018/6480) of patients with non-metastatic CNPC (M0). Totally, combination therapies (ADT plus Doc or Abi) significantly improved overall survival (OS) and failure-free survival (FFS) for all CNPC patients. For M1 patients, combination therapies were dramatically associated with improved OS and FFS, but for M0 patients, only with moderate improvement in FFS. M1 patients with age < 70 years, ECOG performance status (ECOG PS) 0-1, Gleason score ( < 8) or visceral metastases could get better survival benefit from either combination therapies. In indirect comparisons, among M1 patients with younger age ( < 70 years), ECOG PS 0-1 or aggressive Gleason score (GS ≥ 8), upfront Abi showed superiority to Doc in prolonging FFS. The incidence of severe adverse events (AEs ≥ 3) was comparable between these two therapeutic regimens. Conclusions: Upfront Doc or Abi plus ADT should be considered as a standard of care for mCNPC patients who are suitable for either or both of these combination therapies.