Introduction Major thermal injury induces complex pathophysiological state leading to consequences such as catabolism, sepsis, infection, multiorgan failure and death. These hypermetabolic conditions are mediated by catecholamines, pro-inflammatory cytokines and cortisol. A testosterone analog, oxandrolone, is being assessed for its role in counteracting the catabolic state and reducing the hypermetabolic responses post burn. Methodology Pubmed, EMBASE and Cochrane Databases were used for this review. Human subjects that were included has sustained a minimum of 10% TBSA burns and at least superficial dermal in depth. Non-english papers and animal studies were excluded. The measured clinical endpoint includes length of hospital stay, wound healing, lean body mass and bone mineral density. Results 26 randomised controlled trials and 11 observational studies were included with a total of 3014 patients. Oxandrolone is observed to shorten hospital length of stay (9.55 days, p<0.01), higher survival rate and reduce wound healing time of both the donor and graft site (2.75 days p<0.01). It also restores body weight (p<0.01), preventing reduction of lean body mass (p<0.01) and bone mineral density (p<0.01). Conclusion Current available literature suggests that Oxandrolone is beneficial in the acute burn population. It is an anabolic agent that prevents hypermetabolism in both adult and pediatric burn patients with minor side effects. Further research into the pathophysiological response to severe burn is indicated.