Aims: Over the last two decades, the existence of an open access citation advantage (OACA)—increased citation of articles made available open access (OA)—has been the topic of much discussion. While there has been substantial research to address this question, findings have been contradictory and inconclusive. We conducted a systematic review to compare studies of citations to OA and non-OA articles. Methods: A systematic search of 17 databases attempted to capture all relevant studies authored since 2001. The protocol was registered in Open Science Framework. We included studies with a direct comparison between OA and non-OA items and reported article-level citation as an outcome. Both randomized and non-randomized studies were included. No limitations were placed on study design, language, or publication type. Results: A total of 5,744 items were retrieved. Ultimately, 134 items were identified for inclusion. 64 studies (47.8%) confirmed the existence of OACA, while 37 (27.6%) found that it did not exist, 32 (23.9%) found OACA only in subsets of their sample, and 1 study (0.8%) was inconclusive. Studies with a focus on multiple disciplines were significantly positively associated with finding that OACA exists in subsets, and are less associated with finding that OACA did not exist. In the critical appraisal of the included studies, 3 were found to have an overall low risk of bias. Of these, one found that an OACA existed, one found that it did not, and one found that an OACA occurred in subsets. Conclusions: As seen through the large number of studies identified for this review, OACA is a topic of continuing interest. Quality and heterogeneity of the component studies pose challenges for generalization. The results suggest the need for reporting guidelines for bibliometrics studies.