Orthognathic surgery is a surgical procedure aimed at rectifying facial skeletal components and restoring the normal anatomical and functional connections in individuals with dentofacial skeletal abnormalities. These abnormalities derive from either the dento-alveolar complex, the skeletal base, or both, and can manifest as horizontal mandibular excess, deficiency, and/or asymmetry. They manifest in three distinct manners: antero-posterior, transverse, and vertical orientations. Before delving into the classification of jaw deformities, it is imperative to meticulously evaluate the interrelationship between the lower jaw and the rest of the face. Multiple objective parameters are employed to assess the deformity, with clinical evaluation holding paramount importance [
1‐
3]. A significant aspect of orthognathic surgery involves the utilization of bilateral sagittal split osteotomy (BSSO), which is the prevailing procedure for jaw surgery, whether performed independently or in conjunction with upper jaw surgery. The indications for a bilateral sagittal split encompass cases of horizontal mandibular excess, deficiency, and/or asymmetry. This particular technique is widely employed for mandibular advancement, serving as the primary method, and can also be utilized for modest to moderate mandibular setback procedures [
3]. Numerous complications are associated with BSSO such as the risk of improper split, potential injury to the neurovascular bundle, temporomandibular joint (TMJ) issues, excessive bleeding, and the possibility of relapse [
1,
32]. The lingual nerve, a derivative of the mandibular division (V3) of the trigeminal nerve (CN V), supplies sensory information to the lingual gingiva and the anterior two-thirds of the tongue. It is important to acknowledge that the chorda tympani nerve, which is responsible for gustatory perception in the anterior two-thirds of the tongue, converges with the lingual nerve at the level of the lower border of the lateral pterygoid muscle. It is imperative to recognize that damage to the lingual nerve can potentially harm the chorda tympani nerve, leading to changes in taste and sensory perception on the affected side. Individuals affected by such injuries commonly encounter significant discomfort during basic activities like chewing, eating, and speaking. The specific character and severity of altered sensations can vary significantly among individuals, encompassing a variety of symptoms such as paresthesia (unusual sensations like pins and needles), hypesthesia (reduced or complete loss of sensation), and dysesthesia (abnormal sensations such as pain) [
4‐
6]. In the context of orthognathic surgery, a crucial knowledge gap arises regarding the prevalence of lingual nerve injury following bilateral sagittal split osteotomy (BSSO). This gap is apparent due to the substantial heterogeneity observed across scientific publications [
7‐
9], underscoring the necessity for a more precise and comprehensive understanding of lingual nerve damage in the aftermath of BSSO procedures. Consequently, the objective of the present investigation is to provide a more accurate assessment of the occurrence of lingual nerve damage following BSSO, through a meta-analysis of the existing data found in the scientific literature.