Data sources Medline, Scopus and Cochrane Library databases supplemented by searches in the journals; American Journal of Dentistry, Clinical Oral Investigation, International Journal of Prosthodontics, Journal of Dental Research, Journal of Oral Rehabilitation, Journal of Prosthodontics, Journal of Prosthodontic Research, Journal of Advanced Prosthodontics and Journal of Prosthetic Dentistry. Study selection Randomised controlled trials (RCTs) or prospective studies comparing bilateral balanced occlusion (BBO) with other schemes, eg lingual occlusion (LO) canine guidance (CG) and neutral-centric or zero-degree (ZD). Data extraction and synthesis One reviewer extracted the data and two reviewers assessed risk of bias using the Newcastle-Ottawa scale for non-randomised studies and the Cochrane risk of bias tool for RCTs. A narrative summary of the findings was presented. Results Seventeen studies, 11 RCTs and six prospective studies involving a total of 492 were included. Average follow-up period was 2.96 months (range 1-6 months). Six RCTs were considered to be at low risk of bias, two at unclear risk and three at high risk. Studies compared BBO with LO, CG and ZD. Twelve out of 16 studies reported on quality of life and patients’ satisfaction. Conclusions The present systematic review indicated that BBO does not confer better quality of life/satisfaction or masticatory performance and muscle activity. Thus, lingualised occlusion can be considered a predictable occlusal scheme for complete dentures in terms of quality of life/satisfaction and masticatory performance, while canine guidance can be used to reduce muscular activity.