26 studies were included in this systematic review (1 RCT, 11 prospective comparative cohort studies, 14 retrospective comparative cohort studies) comparing the surgical outcomes, clinical outcomes, and complication rates between minimally invasive surgery (MIS), and open transforanimal or posterior lumbar interbody fusion (Open) (856 patients in the MIS group and 806 patients in the Open group). Results indicated comparable surgical times between groups, but lower blood loss, shorter hospital stay, and longer fluoroscopy times with MIS. Clinical outcomes were similar between groups with a trend towards fewer complications with MIS. However, these results should be interpreted with caution as all studies were graded as low-quality, with a high risk for bias.