Over the past decades, extensive experimental-based research works have been carried out to investigate the flashover phenomenon on the performance of polluted transmission line insulators. The critical focus has been on developing methods that can determine the safety, reliability, and sustainability of the overall power transmission network based on experimental results obtained from polluted insulators' flashover voltage tests. In this paper, a systematic review of available scientific works, published as early as the 1990s, for the analysis of pollution flashover voltage, is undertaken. The review mainly focuses on factors influencing the efficiency of transmission line insulators under polluted conditions. Specifically, publication databases utilizing various synonyms and keywords associated with the terms "contaminated insulators" and "flashover voltage test" have been scrutinized. The search has resulted in 1364 articles, from which 97 articles have satisfied the review requirements and have been subsequently analyzed to determine the parameters associated with polluted insulators. Major factors that affect the performance of insulators, including electrical and environmental impacts, are discussed. Variations in factors affecting flashover test development and insulator efficiency are also considered. Overall, the current analysis provides an important insight toward successful evaluations of the health of transmission line insulators and research advancements of electric power transmission line insulators.INDEX TERMS Flashover voltage test, polluted insulators, high voltage insulators, transmission line.