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To systematically analyze the role of heated humidified carbon dioxide (CO2) in laparoscopy.Clinical trials on laparoscopic procedures using standard dry CO2 versus heated humidified CO2 for pneumoperitoneum were analyzed.Ten randomized controlled trials on 565 patients were analyzed. In both the fixed and random effect models, postoperative pain was significantly less in heated humidified CO2 group. Heated humidified CO2 group was also associated with significantly lower risk of hypothermia and lower analgesic requirement. However, statistically there was no difference in total hospital stay and lens fogging rate.The use of heated humidified CO2 for pneumoperitoneum in laparoscopic procedures is associated with lesser postoperative pain, lower risk of postoperative hypothermia, and lower analgesic requirements. However, total hospital stay and lens fogging rates do not differ. Hence, the heated and humidified CO2 may be considered as the first choice for pneumoperitoneum in laparoscopic procedures.