Objective The quality evaluation and content analysis of the existing guidelines concerning management of patient-controlled analgesia(PCA) in adult patients with postoperative acute pain were conducted to provide recommendations for its management. Methods Evidence-based guidelines involving recommendations of PCA management with postoperative pain were searched in guidelines networks,websites of pain management and anaesthesiology,and databases from inception to April 2021. AGREE Ⅱ was used to appraise the quality of guidelines;the recommendations related to PCA management of postoperative pain were synthesized. Results A total of 783 pieces of the literature were initially detected,and finally 9 evidence-based guidelines were included,among which 3 were rated as A and 6 were rated as B,with the relatively high quality. 23 recommendations were extracted and summarized from 9 guidelines,involving 6 domains,namely organization management,education and training,analgesia mode selection,patient education,preoperative assessment,and postoperative monitoring and assessment. Conclusion The guidelines are of high quality in total,providing recommendations on PCA management of postoperative pain;however,the independence and applicability of the guidelines need to be improved. The recommendations of PCA management are scattered in different guidelines and lack targeted specific PCA management strategies.