Background: To compare the efficacy and safety of Chinese herbal medicine combined with nucleoside antiviral drugs and nucleoside antiviral drugs alone in treating recurrent genital herpes. Methods: PubMed, Embase, Web of Science, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Internet, VIP Database, and Wanfang Data were searched from inception to April 2021. Randomized controlled trials on the efficacy and safety of oral Chinese herbal medicine combined with nucleoside antiviral drugs for recurrent genital herpes were collected. All included trials were independently assessed by two reviewers with the Cochrane risk-of-bias tool, and a meta-analysis was conducted using Review Manager 5.4. Results: Compared with the use of nucleoside antiviral drugs alone, combination therapy with oral Chinese herbal medicine plus nucleoside antiviral drugs effectively reduced the herpes recurrence rate after the end of treatment (3 months: P = 0.0002; 6 months: P < 0.00001; 1 year: P < 0.00001) and the number of recurrences each year (P < 0.00001), improved the recurrent Genital Herpes Quality of Life Questionnaire score (P < 0.00001), and regulated the levels of interferon-gamma, interleukin-2, tumor necrosis factor-alpha, and T lymphocyte subsets in the peripheral blood, and the difference was statistically significant. Different subgroups reported mixed results with respect to the efficacy in the short term. The incidence of adverse reactions and the time of symptom disappearance between the two groups were not significantly different. Conclusion: Chinese herbal medicine combined with nucleoside antiviral drugs can effectively reduce the recurrence rate of recurrent genital herpes, improve the patient's quality of life and enhance the body's immunity. Considering the possible risk of publication bias, more high-quality randomized controlled trials are still needed to verify the conclusions of this article.