Highlights • 88 prospective, clinical trials (1996–2015) were analyzed in terms of survival of posterior composite restorations. • Significant findings were only observed for short-term studies and by including all studies (short- and long-term studies). • The observation period, the recall rate, the ratio of Class I/II fillings and the number of restorations/patients had a significant influence on the overall failure rate when including all studies (short- and long-term). • No influence of operator status, isolation method or bonding systems on the overall failure rate was found. • In this study a trend of excluding patients at-risk (e.g. high caries activity) and including patients with good oral hygiene was identified, which produces more favorable results.