Background/Objectives: Orthognathic surgery represents a surgical modality for the correction of craniofacial skeletal deformities. These procedures help achieve stable occlusion and improve facial symmetry, which in turn enhances functional outcomes and overall quality of life. However, to date, no consensus has been reached regarding whether orthognathic surgery also induces changes in the relationship of articular surfaces within the temporomandibular joints (TMJs). The primary objective of this study was to conduct a systematic review of research evaluating joint space dimensions based on CBCT imaging performed before and after orthognathic surgery. Methods: A comprehensive literature search was carried out across four electronic databases: PubMed, Web of Science, Cochrane Library, and Scopus. Two independent reviewers screened titles and abstracts according to predefined inclusion criteria. Eligible studies were subjected to critical appraisal, and relevant data were systematically extracted and summarized in tabular form. Results: Fourteen studies published between 2010 and 2024 met the inclusion criteria. In all studies, CBCT-based joint space measurements were conducted at least twice once preoperatively and once postoperatively, across a total of 527 patients included in the review. Conclusions: The synthesized evidence suggests that orthognathic surgery produces measurable modifications in the spatial relationship of TMJ articular surfaces. Nonetheless, the clinical relevance of these alterations appears to be modulated by several variables, including the surgical technique employed and the patient’s individual adaptive capacity.