This review provides a comprehensive analysis of studies investigating the impact of occupational exoskeletons on work-related musculoskeletal disorder (WMSD) risk factors. The primary objective is to examine the methodologies used to assess the effectiveness of these devices across various occupational tasks. A systematic review was conducted following the PRISMA guidelines, covering studies published between 2014 and 2024. A total of 49 studies were included, identified through searches conducted in Scopus and Web of Science databases, with the search string launched in August 2024. The review identifies a growing body of research on passive and active exoskeletons, with a notable focus on laboratory-based evaluations. The results indicate that direct measurement and self-report methods are the preferred approaches in these domains. Ergonomic limitations and user discomfort remain concerns in some cases. The findings of this review may influence stakeholders by providing insights into the potential benefits of adopting exoskeletons and improving workplace ergonomics to reduce WMSD risks. Additionally, the identification of WMSD assessment methods will be valuable for validating the use of these technologies in the workplace. The review concludes with recommendations for future research, emphasizing the need for more real-world assessments and improved exoskeleton designs to enhance user comfort and efficacy.