Surgical drains are commonly used in vascular surgery to control fluid buildup and reduce postoperative complications; however, their overall benefit remains uncertain due to inconsistent findings and the absence of standardized guidelines. This systematic review aimed to evaluate the role of surgical drains in vascular procedures such as carotid endarterectomy, aortic aneurysm repair, and peripheral arterial bypass, particularly in relation to complications, wound healing, length of hospital stay, and patient recovery. A comprehensive search was conducted across PubMed, Embase, Cochrane, and Google Scholar, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies included randomized controlled trials (RCTs), cohort, and case-control studies that reported on relevant clinical outcomes. Nine studies met the inclusion criteria. The findings revealed mixed results regarding the effectiveness of drains in reducing complications such as hematoma and bleeding, with some benefits noted in specific patient populations. However, an increased risk of surgical site infections was frequently observed with drain use. In certain procedures, such as abdominal aortic aneurysm repair, drains may help prevent the increase in postoperative intra-abdominal pressure, although their influence on overall recovery remains unclear. Given these variable outcomes, the routine use of surgical drains in vascular surgery cannot be universally recommended. Instead, their application should be tailored based on individual patient risk factors and the complexity of the surgical procedure. Additional high-quality studies are needed to develop clear, evidence-based guidelines for their use.