Recent evidences are revealing the role of oxytocin in the pathophysiology of post-traumatic stress disorder (PTSD) and its possible application in prevention and the treatment of PTSD. Aim of the present article is to provide a systematic review of randomized controlled trials (RCT) of clinical effects of oxytocin in PTSD and trauma-related disorders was conducted. Only six articles were selected after applying the inclusion and exclusion criteria. We compared acute and long clinical effects of oxytocin administration on acute trauma symptomatology and PTSD. The acute clinical effects of oxytocin remain unclear, despite some studies show a reduction of global or single cluster of PTSD and of others clinical symptomatology. The long clinical effects of oxytocin administration show a non-statistically reduction of PTSD, although effect of oxytocin seem to be correlated to the severity on acute PTSD symptom. In fact, the presence of high acute PTSD symptoms showed significantly lower PTSD symptom severity across follow-up, indicating a long-term protective effect of oxytocin administration. Future clinical studies, with accurate psychopathological assessments and a structured clinical follow-up, are mandatory to understand the clinical efficacy of oxytocin administration in patients with PTSD or in patients with acute distress and an increasing risk in developing PTSD.