There is ongoing debate about the necessity of antibiotic prophylaxis regarding temporomandibular joint (TMJ) surgery. With antibiotic resistance being a major concern and challenge, developing solid recommendations on antibiotic use is essential to prevent overuse, misuse, and to enhance patient safety. The aim of this systematic review (SR) was to evaluate the scientific evidence regarding the effectiveness of antibiotics in preventing postoperative infections following TMJ surgery. Comprehensive literature searches were conducted using The Cochrane Library, Medline, EMBASE, and Web of Science. The selection process was based on predefined criteria, followed by a quality assessment of the retrieved SRs and primary studies using ROBIS and GRADE, respectively. Out of 8976 studies identified, 20 were reviewed in full text, and two were included in this SR for a risk of bias assessment. The quality assessment revealed a generally high risk of bias. In conclusion, no evidence-based recommendation can currently be made regarding antibiotic usage in relation to TMJ surgery. There is a knowledge gap concerning the impact of antibiotics on postoperative infection in TMJ surgeries, underscoring the need for further research in this field.