OBJECTIVES: To systematically review the effect of preoperative education on reducing postoperative pain and disability in the short-term and long-term for patients undergoing orthopedic surgery. METHODS: Pertinent randomized controlled trials were retrieved from PubMed, Cochrane Central, Embase, Medline, Scopus and CINAHL from their inception until September 10, 2023. Two authors independently conducted study selection, data extraction, and methodological quality assessment. This review was registered in PROSPERO (CRD42023470282). RESULTS: A total of 37 RCTs were included with 27 of them being pooled for meta-analysis. Low certainty of evidence indicated that there was a small effect of preoperative education (standardized mean difference = - 0.23, 95 % CI = [- 0.39, - 0.07], p = 0.004) or combined preoperative intervention (standardized mean difference = - 0.25, 95 % CI = [- 0.41, - 0.09], p = 0.003) on postoperative pain relief. CONCLUSIONS: Preoperative education and combined preoperative intervention only had a short-term effect on postoperative pain relief, while they were not superior to usual care in postoperative functional recovery, either short-term or long-term. PRACTICE IMPLICATIONS: Both preoperative education and combined preoperative intervention are effective in pain control around a week postoperatively. However, optimal contents, durations, and dose of education warrant further investigation.