Objective: To determine the reproducibility of biomedical systematic review search strategies. Design: Cross-sectional meta-research study. Population: Random sample of 100 systematic reviews indexed in MEDLINE in November 2021. Main Outcome Measures: The primary outcome measure is the percentage of systematic reviews for which all database searches can be reproduced. This was operationalized as fulfilling six key PRISMA-S reporting guideline items (database name, multi-database searching, full search strategies, limits and restrictions, date(s) of searches, and total records) and having all database searches reproduced within 10% of the number of original results. Results: The 100 systematic review articles contained 453 database searches. Of those, 214 (47.2%) provided complete database information (named the database and platform; PRISMA-S item 1). Only 22 (4.9%) database searches reported all six PRISMA-S items. Forty-seven (10.4%) database searches could be reproduced within 10% of the number of results from the original search; 6 searches differed by more than 1000% between the originally reported number of results and the reproduction. Only one systematic review article provided the necessary details for all database searches to be fully reproducible. Conclusion: Systematic review search reporting is poor. As systematic reviews and clinical practice guidelines based upon them continue to proliferate, so does research waste. To correct this will require a multi-faceted response from systematic review authors, peer reviewers, journal editors, and database providers.