The mass transfer mechanism between karst conduit and overlapping matrix is often described by a first-order mass transfer (or exchange) coefficient. Nonetheless, the experimental identification and/or proper characterization of this parameter at the domain of interest is rather difficult, and it might not even be possible. For this reason, the mass exchange coefficient between the karst conduit and matrix is mostly inferred from the dual-domain mass transfer modelling approaches such as two-region nonequilibrium model (2RNE) via a set of model calibration. In this study, to enhance our understanding on the mass transfer mechanism between karst conduit and matrix, we performed a systematic literature review and meta-analysis by following a guideline called “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)”. Through a meta-analysis of the selected published papers, we synthesized the accumulated knowledge on the mass transfer mechanism in karst systems, and thus provided a summary about the dual-domain mass transfer characteristics. Our meta-analysis revealed that the mass exchange coefficient is dependent on the (mean) conduit flow velocity while establishing a statistical relationship between these variables is rather complicated, likely due to the uniqueness of the mass transfer parameters at differing scales. With this review, we addressed the potential uncertainties in the dual-domain mass transfer model results, as well as the scientific challenges we must face for the description of the karst transport dynamics.