Abstract Artificial intelligence (AI) is an accurate screening tool for diabetic retinopathy (DR), the leading cause of blindness among working-aged adults. However, its impact on referral uptake is uncertain. We searched Embase, MEDLINE, Scopus, Web of Science and Cochrane Library databases from year 2000 to February 17, 2025. Randomised and non-randomised studies comparing referral uptake after AI-assisted DR screening versus standard of care were included.