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Background The SpineJack system is a minimally invasive device designed to restore vertebral height and stability in vertebral compression fractures (VCFs). This systematic review and meta-analysis evaluates its clinical efficacy, safety, and potential advantages over conventional treatments.Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, Embase, and Scopus were searched on July 20, 2024, for original clinical studies involving adult patients with VCFs treated using the SpineJack system. Studies reporting quantitative outcomes such as pain (Visual Analog Scale, VAS), disability (Oswestry Disability Index, ODI), and vertebral body height (VBH) restoration were included. Data were pooled using random-effects models, and publication bias was assessed through funnel plots and regression analysis.Results 18 studies comprising 1482 patients (930 treated with SpineJack) met the inclusion criteria. Fracture etiologies included osteoporotic, traumatic, and pathologic. Meta-analysis demonstrated significant reductions in pain (VAS standardized mean difference (SMD) 2.26, 95% CI 1.68 to 2.84, P<0.001) and disability (ODI SMD 3.64, 95% CI 2.91 to 4.38, P<0.001). Restoration of anterior VBH (SMD 1.45, 95% CI 1.12 to 1.78, P<0.001, I²=0%), and middle VBH (SMD 3.93, 95% CI 1.51 to 6.34, P=0.001) were both significant. Reported complications were infrequent and primarily minor.Conclusion The SpineJack system provides a safe and effective minimally invasive option for VCF management, yielding considerable improvements in pain relief, functional recovery, and vertebral height restoration. Additional high-quality studies are warranted to further define its comparative advantages and long-term outcomes.