Aims: Diabetic foot osteomyelitis (DFO) is the leading cause of non-traumatic limb amputation and is treated with a combination of wound care, antibiotics, and surgery. The use of antibiotic-impregnated bioresorbable bone filler (ARBF) for limb salvage in DFO compared to conventional treatment has not been systematically evaluated. This study conducted a comprehensive literature review and meta-analysis. Methods: MEDLINE, Embase, and CENTRAL were systematically searched for randomised controlled trials (RCTs) and observational studies. Quality was assessed using the Newcastle-Ottawa Risk of Bias Assessment Tool. Outcomes meta-analysed include limb salvage and wound healing. Qualitative synthesis of literature was performed to assess patient mortality, re-intervention, recurrence of infection. Certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Results: One RCT and 12 observational studies (860 participants) were identified. 3 studies were identified for meta-analysis with a control cohort. Risk of bias was low in most evaluated studies. ARBF may reduce the risk of major amputation (3 studies, 289 participants, RR 0.12, 0.03-0.41, I2 = 0; low certainty of evidence). ARBF treatment trended to improved wound healing but was not statistically significant (2 studies, 153 participants, RR 2.0, CI 95% 0.41 – 9.67, I2 = 96%; low certainty of evidence). Qualitative analysis (13 studies) identified a trend towards lower incidence of repeat intervention and lower risk of infection recurrence (11.8%, 8 studies, 476 participants). However, there was significant inconsistency in reporting. All-cause mortality for ARBF patients was 18.4% (7 studies, 434 participants). Conclusions: ARBF treatment of DFO, compared to conventional therapy, may lead to improved rates of limb salvage and wound healing. A high-quality RCT is necessary to confirm this conclusion due to a low certainty of evidence.