Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder, with tolvaptan remaining the primary disease-modifying therapy. SGLT2 inhibitors have demonstrated robust renoprotection across the chronic kidney disease (CKD) spectrum, yet patients with ADPKD have been systematically excluded from pivotal trials due to concerns over vasopressin-mediated cystogenesis. This systematic review and meta-analysis aimed to pool available evidence on SGLT2 inhibitor use