Aims: Intravenous ibuprofen (IVIB) has been approved in the treatment of postoperative pain and fever in adults, but the application of multiple- or single- dosage IVIB remains divergent in clinical practice. This study aims to evaluate the efficacy and safety of IVIB in the management of postoperative pain and fever in adults who were unable to take oral medicine. Methods: A systematic review and meta-analysis was conducted based on randomized controlled trials (RCTs) regarding postoperative pain and fever management comparing IVIB with placebo, or other analgesic and antipyretic agents from 8 databases. Risk of bias and quality of evidence assessment were performed. The primary outcomes mainly included visual analogue scale (VAS) score within postoperative 24h and the reduction of temperature. Results: Twenty-three RCTs with 3716 participants were included. For postoperative pain, moderate-to-low certainty evidence indicated that IVIB was associated with lower postoperative VAS scores than placebo, with MD ranging between -3.53 (95% CI, -4.32 to -2.75) at 0 minute to -0.96 (95% CI, -1.35 to -0.57) at 24 hours. Compared to intravenous acetaminophen, IVIB appeared lower VAS scores (MD, -1.54 at 0min; -0.36 at 24h). For fever, IVIB appeared satisfactory antipyretic efficiency in a short period of time, but there was no difference between IVIB and intravenous acetaminophen. Moderate-to-low certainty evidence indicated that IVIB was well tolerated in both pain and fever management. Conclusions: Moderate-to-low certainty evidence supported that adults with postoperative pain and fever who were unable to take oral medicine would benefit from IVIB.