Ovarian cancer remains a significant cause of morbidity and mortality among women worldwide. High-risk groups, particularly those with BRCA1 and BRCA2 mutations, require effective preventive strategies. Prophylactic bilateral salpingectomy has been proposed as an alternative to bilateral salpingo-oophorectomy (BSO) to reduce cancer risk while preserving ovarian function.

To evaluate the effectiveness of prophylactic bilateral salpingectomy in reducing the incidence of ovarian cancer among high-risk women compared to no intervention or alternative risk-reducing surgeries, such as BSO.

A systematic review and meta-analysis were conducted following the PRISMA guidelines. We searched PubMed, Cochrane Library, and Scopus for studies published in the last 20 years. The inclusion criteria were randomized controlled trials, cohort studies, case–control studies, systematic reviews, and meta-analyses that evaluated the incidence of ovarian cancer following prophylactic bilateral salpingectomy. The primary outcome was the incidence of ovarian cancer. Secondary outcomes included ovarian cancer mortality, quality of life, psychological impact, and surgical complications.

Nine studies were included, comprising a total of 1865 participants. Prophylactic bilateral salpingectomy was associated with a significant reduction in the incidence of ovarian cancer (pooled risk ratio [RR] 0.30, 95% CI 0.26–0.34) compared to the control groups (no surgery or BSO). Mortality from ovarian cancer also decreased significantly (pooled RR 0.50, 95% CI 0.35–0.70). Quality of life scores were higher in the salpingectomy group, with fewer negative psychological outcomes. Surgical complications were similar between groups.

Prophylactic bilateral salpingectomy significantly reduces the risk of ovarian cancer in high-risk women, with a favorable safety profile and improved quality of life outcomes. Further research should investigate long-term effects and the biological mechanisms underlying this preventive strategy.