Living donor liver transplantation is a valid alternative to deceased donor liver transplantation, and its safety and feasibility have been well determined. Minimally invasive living donor hepatectomy (MILDH) has taken some time to be accepted because of inherent technical difficulties and the highly demanding surgical skills needed to perform the procedure, and its role is still being debated. Because of the lack of data, a systematic review and meta-analysis comparing MILDH and open living donor hepatectomy (OLDH) was performed. A systematic literature search was performed with PubMed, Embase, Scopus, and Cochrane Library Central. Treatment outcomes, including blood loss, operative time, hospital stay, analgesia use, donor-recipient morbidity and mortality, and donor procedure costs, were analyzed. There were 573 articles, and a total of 11, dated between 2006 and 2014, fulfilled the selection criteria and were, therefore, included. These 11 studies included a total of 608 adult patients. Living donor liver transplantation (LDLT) is a therapeutic modality alternative to liver transplantation with a deceased donor. The first procedure was described in 1989 by Raia et al., 1 and Strong et al. 2 performed the first successful pediatric LDLT in 1990. Its safety and feasibility have been well documented over the past several decades, and it is considered a valid and lifesaving procedure, especially in countries where there are few or no options for deceased organ donation. However, LDLT is accompanied by a certain donor morbidity risk that has hindered adoption of the procedure for routine use worldwide. [3][4][5] Morbidity still represents an important issue, with rates ranging between 20% and 40%; it Additional Supporting Information may be found in the online version of this article.