Background: It is accepted in several areas of surgery that prehabilitation can improve post-operative outcomes. Prehabilitation describes preoperative interventions aimed at optimising patient condition prior to surgery. Method: A systematic search was performed based on a research question formulated according to the PICO framework in several databases. Eligible studies were those that included a predefined prehabilitation intervention, a comparison to usual care and conducted on patients undergoing upper gastrointestinal surgery. Included studies were evaluated for bias and underwent data extraction. Meta-analysis was also performed for outcomes where possible. Results: Eight studies met criteria for inclusion. There was a large amount of variability in surgical procedures included and prehabilitation programs varied widely, with interventions lasting from 2-6 weeks with several modalities. Participants tended to be older, with all trials having an average age of sixty or above. Reported outcomes included post-operative pulmonary complications, mortality and length of hospital stay. A meta-analysis was undertaken for mortality and postoperative pulmonary complications. This showed postoperative pulmonary complications were reduced (RR0.68, 95% CI 0.50-0.93) in the intervention group compared to the control group, as was mortality (RR 0.59, 95% CI 0.35-1.00). Conclusions: Prehabilitation, especially inspiratory muscle training appears to be effective in reducing pulmonary complications in patients scheduled for upper gastrointestinal surgery. There is scope for further research to better define a role for prehabilitation in upper gastrointestinal surgery, specifically the optimal prehabilitation modality and length.