Objective <p>Patient and public involvement and engagement (PPIE) entails working with patients and the public to shape research. The Guidance for Reporting Involvement of Patients and the Public (GRIPP2) checklist aims to improve the quality and consistency of the PPIE evidence base. This study reviews PPIE in Otolaryngology randomized controlled trials (RCTs) published since introduction of the GRIPP2.</p> Methods <p>This systematic review was conducted according to the PRISMA 200 guidelines and pre-registered on the PROSPERO database CRD42023448519. A robust systematic review filtered ten manuscripts into the final analysis. Study characteristics; GRIPP2 short form categories; PPIE utilisation, role, and impact data were extracted.</p> Results <p>Only 10 out of 346 (3%) of Otolaryngology RCTs published since 2018 described the use of PPIE. None referred to the GRIPP2 checklist. Most studies incorporating PPIE did so for the production and approval of patient-facing material review (50%). It was not possible to determine PPIE impact on patients, or the clinical impact of PPIE in the studies which incorporated it.</p> Conclusion <p>Future Otolaryngology trials should incorporate and report PPIE, which has the potential to generate benefit for all stakeholders.</p>