This paper systematically reviews 314 empirical studies that examine the relationship between board leadership structure and firm performance. The results show that the mixed research findings are due to different firm performance measurements, research designs, sampling practices and approaches of dealing with endogeneity issues. Studies utilizing multiple-country data, multinational companies, small firms or regions covering Africa, the Middle East, Eastern Europe and South America are under-represented. It critiques the methodological weaknesses of some empirical studies and proposes that future researchers should use multiple firm performance measurements, a longitudinal research design and an integrative framework to better control the direct and moderating factors. Future researchers may advance the robustness of research by using multiple theoretical lenses to consider how various governance factors moderate the relationship between board leadership structure and firm performance, particularly the different ownership structures, managerial discretion contexts and national institutional factors.