Background: Ring external fixators are used to create a gradual straightening of tibia vara through an osteotomy site. This systematic review aimed to examine the studies that reported the outcomes of gradual correction of tibia vara with ring fixators. Methods: MEDLINE, Cochrane library, CINAHL databases have been enquired. Eligibility criteria included studies that were written in English and conducted on humans affected with tibia vara managed with ring fixators on gradual mode. Experimental studies on cadavers or virtual models, or studies with insufficient data were excluded. Two review authors have independently judged the individual studies for eligibility. Results: Eleven studies containing 205 patients were included. Tibia vara gradual correction with ring fixator has shown satisfactory outcomes. Mechanical axis deviation improved Desired values of medial proximal tibial angle, and posterior proximal tibial angle have been restored by the end of treatment course. Conclusions: The review demonstrated a utilitarian capability of ring fixators in running gradual correction programs in tibia vara. Flawless pre-operative planning is an essential prerequisite for perfect outcomes. Keywords: genu varum; gradual correction; Ilizarov method; osteotomy; ring fixator; tibia vara