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<b>Introduction:</b> In recent years, new treatments for chronic rhinosinusitis (CRS) have been sought, among which steroid-eluting implants (SEIs) are one of the most effective. <br><br><b>Aim:</b> The aim of the systematic review was to collect available studies on the use of SEIs in CRS. <br><br><b>Materials and methods:</b> A systematic review according to PRISMA (4 databases: PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library) as of March 17, 2025, including full-text original papers in English. Risk of bias was assessed using the Cochrane and JBI critical appraisal. <br><br><b>Results:</b> In total, 347 articles were identified, 26 of which met the inclusion criteria for the analysis, covering a population of 9311 patients. Most investigators confirmed the efficacy of SEIs in improving SNOT, endoscopic nasal assessment, reducing polyps, and reducing postoperative adhesions, and a non-significant role in lateralization of the middle turbinate. SEIs reduced the need for oral steroids and the risk of sinus reoperation comparably to intranasal steroids. Side effects of SEI therapy were mild and included parosmia, nose bleeding, headache, and nasal pain, sinusitis, discomfort, and local swelling in the nose. <br><br><b>Conclusions:</b> SEIs are effective and safe, but prospective cohort studies with long postoperative follow-up are desirable.