Objective Exploring the changes in renal cortical microcirculation and quantitative parameter characteristics of contrast-enhanced ultrasound (CEUS) after allogeneic kidney transplantation, providing evidence-based evaluation for CEUS in kidney transplantation. Methods Combine theme words with relevant free words and conduct literature searches on databases such as Embase, MEDLINE, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP (2000-2023). Collect relevant studies on contrast-enhanced ultrasound evaluation of renal cortical microcirculation after allogeneic kidney transplantation. Perform a meta-analysis and systematic review according to the PRISMA (Preferred Reporting Items for systematic reviews and meta-analysis) guidelines. Results 11 studies(977 kidney transplant patients) were included. The overall quality included in the study ranges from medium to high. Meta analysis showed that the area under the curve (SMD: -1.01, 95% CI: -1.38~-0.63) and peak intensity (SMD: -0.55, 95% CI: -1.02~-0.08) of ultrasound contrast parameters in the renal dysfunction group were significantly lower than those in the stable renal function group. The peak intensity (PI) of the group with renal dysfunction was significantly lower than that of the group with stable renal function (SMD: -0.55, 95% CI: -1.02~ -0.08). The time to peak intensity (TTP) was significantly longer in the group with stable renal function (SMD: 0.33, 95% CI: 0.02~0.63). Conclusion Patients with renal dysfunction after allogeneic kidney transplantation have reduced total cortical microcirculation perfusion, decreased renal cortical perfusion intensity, and prolonged perfusion time. CEUS parameters can timely reflect changes in renal cortical microcirculation, providing a basis for early diagnosis of renal dysfunction after transplantation.