Tripterygium wilfordii Hook F (TwHF) is a Chinese herbal medicine with immunosuppressive effects and an established history of use in the treatment of inflammatory and autoimmune diseases. We have carried out a meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs which assessed the effectiveness of TwHF in the treatment for idiopathic refractory nephrotic syndrome (IRNS). After reading the full text, only three RCTs or quasi-RCTs meeting our inclusion criteria were selected. Our meta-analysis indicated that TwHF has beneficial effects on the remission of IRNS. There was no significant publication bias in the meta-analysis studies. However, studies with a larger sample size and including patients with both a mild and severe histopathological change involvement separately are needed to assess the effects of TwHF in IRNS patients before exact conclusions can be drawn.