Background: The Sonopet iQ® Ultrasonic Aspirator is a surgical tool used for the fragmentation and emulsification of bone and soft tissue. Ultrasonic vibrations emulsify bone with cited benefits of decreased damage to surrounding soft tissue and minimal heat dispersion. Despite these potential benefits, there is a paucity of published articles on the safety and efficacy of the Sonopet® in the setting of craniofacial surgery. Methods: In accordance with PRISMA guidelines, MEDLINE and Pubmed were searched for articles that studied use of the Sonopet® for osteotomies in the craniofacial setting. Studies exclusively investigating soft tissue aspiration were excluded. Results: Out of 61 articles discovered, 22 met inclusion criteria and discussed a total of 816 patients. Of the 22 articles, there were 8 retrospective chart reviews, 7 case series, 5 cadaver models, and 2 case reports. Studies spanned multiple disciplines including otolaryngology, ophthalmology, craniofacial surgery, neurosurgery, and oral and maxillofacial surgery. Despite its frequent use in orthognathic and cranial vault remodeling surgery, only 4 studies described its use in these fields. The most commonly cited benefits of the Sonopet® were enhanced ergonomics and safety, discussed in 20 of the included studies. Eighteen studies claimed the Sonopet® was safer to use in surgically tight spaces compared to traditional drills. Four studies found decreased bone dust generation by the Sonopet® compared to conventional cutting devices. No studies reported an increase in postoperative complications due to the device. The most commonly cited disadvantage was the cost of the device, however, the majority of authors believed the benefits of the device outweighed the increase in cost. Conclusions: There is a dearth of research investigating the use of the Sonopet® in craniofacial surgery. Available studies emphasize the ergonomic and safety benefits of the Sonopet® and encourage expanded use of the device despite its cost.