Background: The evolution of adhesive dentistry has increased the demand for improving the clinical outcomes of indirect restorations. There are several challenging factors in restoring teeth with deep interproximal lesions. Surgical crown lengthening has been the primary procedure to avoid violation of the biological width. In recent years, deep marginal elevation (DME) has been proposed as an alternative procedure for maintaining biological width in cases with subgingival defects. The aim of this review was to search for the best available evidence concerning the clinical outcomes of DME. Methodology: A comprehensive online search was performed using three different databases (using PubMed, the Cochrane Library, and the American dental association library for evidence-based dentistry). Four independent authors reviewed studies, collected data, and assessed the risk of bias. Results: The initial search revealed 1,763 studies. Duplicates were removed, and an extensive review was performed. Only six studies met the inclusion criteria and were accepted in the review. Conclusions: The systematic review advocates that DME is a reasonable, predictable, and reliable clinical procedure. There is a limitation of clinical studies in this field; therefore, more clinical studies with long-term follow-up periods are necessary.