Aim To compare the efficacy and safety of bare metal stent (BMS), drug-coated balloon (DCB) and drug-eluting stent (DES) in coronary heart disease patients with high bleeding risk (HBR). Methods Domestic and international electronic databases were searched to collect randomized controlled clinical trials of DCB or DES vs. BMS in coronary heart disease patients with HBR, Meta-analysis was performed using Revman 5.3 software. The primary endpoints of this study were to compare the target lesion revascularization (TLR) rate, recurrent myocardial infarction rate, cardiogenic mortality rate and bleeding rate of DCB and DES vs. BMS in coronary heart disease patients with HBR. The secondary endpoints were to indirectly compare the TLR rate, recurrent myocardial infarction rate, cardiogenic mortality rate and bleeding rate of DCB and DES, so as to compare the clinical effect of the three. Results In coronary heart disease patients with HBR, compared with BMS group, DCB group and DES group had lower TLR rate (RD＝－0.4,5%CI:－ 0.05～0.03, P＜0.05), lower cardiogenic mortality rate (RD＝－0.2,5%CI:－0.04～－0.01, P＜0.05), and lower recurrent myocardial infarction rate (RD＝－0.3,5%CI:－0.05～0.01, P＜0.01). Compared with DES group, DCB group had lower TLR rate (0% vs. 5.5%, RR＝0.6,5%CI:0.00～0.98, P＝0.05) and recurrent myocardial infarction rate (0% vs. 5.8%, RR＝0.6,5%CI:0.00～0.93, P＜0.05). Patients in the three groups were treated with very short dual antiplatelet therapy (DAPT) program, and there was no significant difference in bleeding rate among the three groups. Conclusion In coronary heart disease patients with HBR, DCB and new generation DES combined with short-term DAPT have higher efficacy and safety than BMS.