Background This systematic review investigates newer generation 3-dimensional (3D) laparoscopy vs 2-dimensional (2D) laparoscopy in terms of error rating, performance time, and subjective assessment as early comparisons have shown contradictory results due to technological shortcomings. Data sources This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) comparing newer generation 3D-laparoscopy with 2D-laparoscopy were included through searches in Pubmed, EMBASE, and Cochrane Central Register of Controlled Trials database. Conclusions Of 643 articles, 13 RCTs were included, of which 2 were clinical trials. Nine of 13 trials (69%) and 10 of 13 trials (77%) found a significant reduction in performance time and error, respectively, with the use of 3D-laparoscopy. Overall, 3D-laparoscopy was found to be superior or equal to 2D-laparoscopy. All trials featuring subjective evaluation found a superiority of 3D-laparoscopy. More clinical RCTs are still awaited for the convincing results to be reproduced.