Objectives: The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri‐implant tissue health and to identify the most suitable material and surface characteristics.Methods: A protocol was developed aimed to answer the following focused question: “Which is the effect of the modification of the abutment design in regard to the maintenance of the peri‐implant soft tissue health?” Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow‐up of at least 6 months after implant loading were considered as inclusion criteria. Meta‐analyses were performed whenever possible.Results: Nineteen final publications from thirteen investigations were included. The results from the meta‐analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = −26.96; 95% CI (−45.00; −8.92); p = .003] and less plaque accumulation [n = 1; MD = −20.00; 95% CI (−41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = −0.44; 95% CI (−0.65; −0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences.Conclusions: The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri‐implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments.