We included eighteen controlled trials and cohort studies to conduct our final analysis. Our network comparison found that mortality rate after 90 days significantly reduced in MSU more than Conventional Care (RR = 1.49, 95% CI [1.11; 1.99]), while there was no significant difference after seven days in MSU comparing to hospital, traditional ambulance, and conventional care (RR = 0.38, 95% CI [0.08; 1.77]), (RR = 0.78, 95% CI [0.30; 2.05]), (RR = 1.73, 95% CI [0.71; 4.23]) respectively. Our network comparisons between different therapies after 90 days detected that the mRS score was significantly improved in MSU comparing to hospital, and optimized prehospital management (OPM) (MD = -0.67, 95% CI [-1.32; -0.02]), (MD = -1.67, 95% CI [-2.67; -0.67]) respectively. Regarding Alarm to IV thrombolysis or intra-arterial recanalization, our analysis found that MSU was superior to traditional ambulance, and hospital (MD = -36.83, 95% CI [-43.04; -30.62]), (MD = -37.33, 95% CI [-44.73; -29.93]) respectively.