OBJECTIVE: Percutaneous aspiration sclerotherapy is indicated for treatment of symptomatic renalcysts. The efficacy and safety of the different sclerosing agents have been sources of debate anddisagreement. The purpose of this study was to assess the efficacy and safety of using tetracyclineaspiration sclerotherapy in a systematic review of the literature. MATERIALS AND METHODS: A systematic search was conducted on the following electronic databases:Cochrane Central Register of Controlled Trials, EMBASE, PubMed and HERDIN (until November2017). Studies of cyst volume reduction after tetracycline aspiration sclerotherapy were included forfull text evaluation. The quality of the studies and the risk of bias were assessed independently by theauthors, based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Three studies were included for full-text assessment. They included 87 patients. Overall, riskof bias was high. Complete renal cyst disappearance ranged between 29%-100% after a follow-upperiod of 3-36 months. Partial success/>50% renal cyst reduction ranged between 85.7%-100%.Complications were minor and self-limited, postoperative procedural pain occurred most frequently. CONCLUSION The authors found good results with respect to efficacy and safety after tetracyclineaspiration sclerotherapy of renal cysts. However, due to high risk of bias in the included studies,definite conclusions regarding efficacy could not be drawn.