Background <p>Burn injury triggers barrier loss and dysregulated immunity, predisposing to infection and sepsis. Probiotics have been proposed as an adjunct to modulate mucosal immunity and reduce infectious complications, but clinical findings in burn patients are inconsistent.</p> Methods <p>We conducted a systematic review and meta-analysis of RCTs and cohort studies of probiotic supplementation in burn patients. Databases: PubMed, Embase, and Cochrane CENTRAL (2011- 2025). Primary outcomes were infection and sepsis. Pooled risk ratios (RRs) with 95% CIs were calculated using a prespecified random-effects (DerSimonian–Laird) model; fixed-effect models were used for sensitivity analyses. Prespecified sensitivities included exclusion of Fleming 2019 (heterogeneous cohort) and RCT-only pooling. Protocol registered in PROSPERO (CRD420251050156); PRISMA 2020 followed.</p> Results <p>Five studies (3 RCTs, 2 cohorts; <i>n</i> = 341) met inclusion criteria. Probiotic supplementation was associated with a lower risk of sepsis (RR 0.48, 95% CI 0.29–0.80; I² = 0%). For overall infections, the all-studies model including <i>Fleming</i> 2019 was not significant (RR 0.70, 95% CI 0.33–1.48; I² = 70%), whereas sensitivity analyses excluding <i>Fleming</i> (i.e., RCT-only/less heterogeneous evidence) showed a significant infection reduction (RR 0.50, 95% CI 0.30–0.82; I² = 0%). No serious probiotic-related adverse events were reported; several trials noted lower CRP, higher IgA, and signals of improved wound healing.</p> Conclusions <p>Probiotic use in burn patients appears to be a generally safe intervention and may reduce the risk of infections and sepsis. Although no serious adverse events were reported in the included studies, further large-scale, standardized trials are warranted to confirm these findings and evaluate long-term outcomes.</p> <p><b>Level of Evidence:</b> Not gradable</p>