To evaluate the effectiveness and outcomes of smart or automated sterilization tracking systems in Central Sterile Services Departments (CSSDs) compared with conventional manual methods.

A systematic review was conducted following PRISMA guidelines. PubMed, Web of Science and Embase were searched from January 2010 to July 2025. Studies evaluating automated tracking systems in CSSDs were included. Data on clinical satisfaction, instrument cleaning and packaging qualification rates, and process outcomes were extracted. Study quality was assessed using JBI critical appraisal tools.

Nine studies involving 390,130 instruments and 32 staff members were included. Automated systems consistently outperformed manual methods across reported outcomes. Clinical satisfaction increased by 9–23%. Cleaning qualification rates improved by 1–10%, while packaging qualification rates increased by 4–30%. Process efficiency also improved, with reductions in instrument turnaround times ranging from 1–5 minutes per item to 20 minutes per batch. All included studies were of moderate to high methodological quality.

Smart and automated sterilization tracking systems were associated with improvements in instrument-processing quality, staff satisfaction and operational efficiency compared with manual methods. These systems may support infection control, traceability, patient safety and more efficient CSSD operations. Further research is required to evaluate long-term clinical and economic impacts.