BACKGROUND: Derivo embolization device (DED) is a second-generation flow diverter (FD) that has been increasingly used in the management of intracranial aneurysms (IAs). DEDs consist of 48 nitinol wires with an inner platinum core and a blue-colored coating of oxides and oxynitrides, which mitigates these FDs' thrombogenicity. This systematic review and meta-analysis evaluate the efficacy and safety of DED in IAs. METHODS: On February 25, 2025, a comprehensive search was conducted across PubMed, Embase, Scopus, and Web of Science in accordance with PRISMA guidelines. Studies reporting clinical and radiological outcomes of DED were included. RESULTS: Thirteen studies involving 1125 patients and 1338 aneurysms were included. The meta-analysis revealed a pooled complete occlusion rate of 83% (95% CI: 79%-87%), an adequate occlusion rate of 92% (95% CI: 84%-97%), and a favorable outcomes rate of 97% (95% CI: 92%-100%). Additionally, the meta-analysis demonstrated a pooled adjuvant coiling rate of 15% (95% CI: 7%-26%), a major ischemic complication rate of 1% (95% CI: 0%-2%), and a major hemorrhagic complication rate of 0% (95% CI: 0%-1%). CONCLUSION: The current study's findings revealed that DEDs are associated with promising complete and adequate occlusion rates concurrent with low rates of major ischemic and hemorrhagic complications.