Background <p>Tinnitus represents a phantom auditory phenomenon without concurrent cochlear mechanical or acoustic activity, with its nomenclature stemming from the Latin tinnire. The goal of this extensive study was to investigate the safety and influence of vagus nerve stimulation (VNS) on patient distress and symptom severity.</p> Methods <p>Aligned with PRISMA-2020 standards, this systematic review’s protocol was prospectively registered in PROSPERO (PROSPERO 2022 CRD42022357426).</p> Results <p>Identification of 129 titles via database search: 48 titles from the PubMed, 16 from Google Scholar and 65 from PMC database. After discarding duplicate titles, screening 102 reports by title and abstract, from which 70 reports were excluded for irrelevance. Full texts of 32 reports were retrieved and assessed for eligibility, from which 19 were excluded because of ineligibility. Thirteen studies were eligible, two of which were excluded, both nerve root sleeve injections (NRSI), one study has no valid data, and the other study was nested in another study in our review. Eleven trials, 3 randomized controlled trials (RCT) and 8 nerve root sleeve injection NRSI, were finally included in systematic review and meta-analysis.</p> Conclusion <p>VNS is considered safe and effective in treatment of tinnitus.</p>