Background <p>Despite being the gold standard for chemical plaque treatment, chlorhexidine digluconate (CHX) mouthwash has adverse effects that make it necessary to use alternatives. Essential oil (EO) and cetylpyridinium chloride (CPC) mouthwashes effectively reduce plaque and gingivitis. Hence, the aim of this review is to assess and compare the available data on the efficacy of CPC and EO mouthwashes in reducing plaque and gingivitis.</p> Methods <p>Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Science Direct, Web of Science, and Google Scholar were searched from the earliest available year (1990) till January 10, 2025. PICO Strategy: P<b>:</b> Individuals with plaque and gingivitis; I: CPC mouthwash; C: EO mouthwash; O: Reduction in plaque and gingivitis. The review only comprised randomised controlled trials. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool respectively.</p> Results <p>After meeting the eligibility requirements, seven full-text publications were assessed for qualitative synthesis and six articles for quantitative synthesis. Overall, there was no significant difference in the reduction of plaque and gingivitis between CPC and EO mouthwashes. At two weeks, however, EO demonstrated a greater reduction in gingivitis (SMD: 4.67 [4.08, 5.26]; <i>p</i> &lt; 0.00001; I² = 0%). Both mouthwashes were equally effective at reducing plaque and gingivitis at one, three, and six months.</p> Conclusion <p>While CPC mouthwash matched EO mouthwash’s long-term efficacy, EO mouthwash demonstrated superior short-term anti-gingivitis effects. Both were equally successful in reducing plaque. Depending on the needs of the patient, either can be utilized because of their distinct mechanism of action. Additional research should be done to reduce bias and enhance the methodology.</p> PROSPERO Registration No <p>CRD42025638243</p>