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Background: Protocols are currently being studied in preventing postoperative complications after exodontia., Purpose: This systematic review and meta-analysis aims to evaluate whether the application of intra-alveolar honey reduces inflammatory complications after the extraction of mandibular third molars (CRD 42.023.467.041)., Methods: Searches were carried out in six electronic databases. Clinical trials comparing intra-alveolar honey administration with non-intervention or placebo after mandibular third molar extraction were selected to assess their impact on postoperative inflammatory parameters. The Cochrane ROB 2 tool was used to assess the bias risk in included studies, Stata software to conduct a meta-analysis for quantitative synthesis, and the GRADE system to evaluate the certainty of the evidence., Results: This systematic review included 5 studies with 330 participants, and two studies were included in the meta-analysis. The results of the meta-analysis demonstrated that postoperative pain on the second day [MD: - 1.05; 95% CI - 2 to - 0.1] and fifth day [MD: - 0.97; 95% CI - 1.97 to - 0.03] was lower in the honey group compared to the control group. Total analgesic consumption [MD: - 4.77; 95% CI - 6.73 to - 2.81] was also lower in patients in the intervention group. The descriptive results indicated that honey appears to be beneficial in controlling edema, reducing trismus, and improving healing after extraction of third molars. Alveolar osteitis showed inconclusive results., Conclusions: The use of intra-alveolar honey after extraction of mandibular third molars seem to be associated with pain reduction. For the other outcomes, the results remain uncertain., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)