Twenty studies with 1271 patients were included in this systematic review and meta-analysis comparing low-dose ketamine to normal saline in patients undergoing surgical orthopaedic procedures. The primary outcomes of interest were total opioid consumption, time to first opioid administration and pain scores. Secondary outcomes of interest included the incidences of post-operative nausea and vomiting, hallucinations and chronic pain. Results revealed significantly lower total opioid consumption and pain scores in the first 48 hours in the ketamine group compared to the control group. The time to first opioid administration was significantly longer in the ketamine group compared to the control group. The incidences of nausea and vomiting, hallucinations and chronic pain were similar between the ketamine and control groups.