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The influence of obesity on spine surgery outcomes is highly controversial with a current clinical equipoise. Several studies suggest higher perioperative morbidity with obesity while other studies suggest otherwise. To address this gap in the literature, we conducted a systematic review and meta-analysis in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with the objective of better defining the impact of obesity on outcomes following lumbar spine surgery. Risk of bias assessment was performed using the Newcastle-Ottawa Scale. Strength of evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) Working Group system. Surgical outcomes such as blood loss, operative time, length of stay, complication and reoperation rates and functional outcomes represented by the change in Oswestry …