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Background In steroid-refractory acute severe ulcerative colitis (ASUC), cyclosporine (CYS) or infliximab (IFX) may be considered as a second-line alternative to avoid colectomy. There are short-term data reported, but until now, there is no meta-analysis regarding long-term outcomes of CYS and IFX in patients with ASUC. Aim To compare long-term efficacy and safety of CYS and IFX in a meta-analysis. Methods Three electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials) were searched for studies which compared