Background: The considerable increase in labiaplasty, demands plastic surgeons to be acquainted with the surgical techniques, their respective complications and satisfaction rates. This is a systematic review of the available evidence on labia minoraplasty looking at surgical techniques, clinical outcomes and patient satisfaction. Methods: A comprehensive search across PubMed, Web of Science, SCOPUS and Cochrane CENTRAL was executed through October 2020. A random-effect model meta-analysis was performed to assess the satisfaction and complications rates. Results: Forty-six studies including 3804 patients fulfilled the inclusion criteria. The pooled satisfaction rate following labia minoraplasty was 99% (95%CI: 97%–99%). Substantial heterogeneity was present across studies ( I 2 = 63.09%, p < 0.001). The highest pooled incidence of dehiscence was reported for laser-assisted labiaplasty (5%, 95%CI: 2%–8%) and wedge resection (3%, 95%CI: 1%–5%). The highest pooled incidence of hematoma formation (8%, 95%CI: <1%–23%) and postoperative bleeding (2%, 95%CI: <1%–15%) was reported for W-shape resection. The highest pooled incidence of transient pain or discomfort was reported for deepithelialization (2%, 95%CI: <1%–23%) and W-shape resection (2%, 95%CI: <1%–15%). Three flap necrosis were reported, two occurred using wedge resection labia minoraplasty and one was not specified. The most common causes for revision surgery (n=169) were dehiscence and aesthetic concerns. Conclusion: Overall, labia minoraplasty is a very safe procedure. However, serious complications requiring surgical management have been reported. In this sense, an experienced surgeon, proper knowledge of female genital anatomy, and a thorough technique selection in accordance with the patient characteristics is mandatory.