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Background Postoperative recurrence (POR) of Crohn’s disease remains high. This is potentially due to inadequate surgical technique. The primary aim was to systematically review the literature on the quality of ileocolic resections in reducing recurrence.Methods The EMBASE, Medline and Cochrane Library electronic databases were searched for studies reporting outcomes following ileocolic resection for Crohn’s disease. Quality of surgery was defined as three categories: mode of surgery, nature of mesenteric excision and type of anastomosis.Results 24 studies were included in the review; 4 for mode of surgery, 4 for extent of mesenteric excision and 16 for type of anastomosis (5 RCTs). There is heterogeneity in the reporting of quality of surgery and recurrence. There was no significant difference in recurrence rates with mode of surgery, extent of mesenteric excision and type of anastomosis.Conclusion This systematic review with meta-analysis, undertaken to explore the association between the quality of surgery and POR showed no clear relationship between the mode of surgery, the extent of mesenteric excision, type of anastomosis and Crohn’s recurrence.