Moderate mitral regurgitation (MR) of ischemic etiology has been associated with worse outcomes after coronary artery bypass grafting (CABG). Studies comparing concomitant mitral valve replacement/repair (MVR/Re) with CABG and standalone CABG have reported conflicting results. We performed a systematic review and meta-analysis of the published literature.  We searched using PubMed, Cochrane, EMBASE, CINAHL, and Google scholar databases from January 1960 to June 2016 for clinical trials comparing CABG to CABG + MVR/Re for moderate MR. Pooled risk ratio or mean difference (MD) with 95% confidence intervals (CI) for individual outcomes were calculated using random effects model and heterogeneity was assessed using Cochrane's Q-statistic.  A total of 11 studies were included. Mean follow-up was 35.3 months. All-cause mortality (Mantel-Haenszel [MH] risk ratio [RR]: 0.96, 95% CI: 0.75-1.24,  = 0.775), early mortality (MH RR: 0.65, 95% CI: 0.39-1.07,  = 0.092), and stroke rates (MH RR 0.65, 95% CI: 0.21-2.03,  = 0.464) were similar between CABG and CABG + MVR/Re groups. Adverse event at follow-up was lower with CABG (MH RR: 0.90, 95% CI: 0.61-1.32,  = 0.584). MD of change from baseline in left ventricular (LV) end-systolic dimension (MD: - 2.50, 95% CI: - 5.21 to - 0.21,  = 0.071) and LV ejection fraction (MD: 0.48, 95% CI: - 2.48 to 3.44,  = 0.750) were not significantly different between the groups. Incidence of moderate MR (MH RR: 3.24, 95% CI: 1.79-5.89,  < 0.001) was higher in the CABG only group.  Addition of MVR/Re to CABG in patients with moderate ischemic MR did not result in improvement in early or overall mortality, stroke risk, or intermediate markers of LV function when compared with CABG alone.