The purpose of this study was to update the current evidence regarding the efficacy and safety of the totally thoracoscopic maze (TT-maze) procedure for the treatment of atrial fibrillation (AF). Fourteen studies published between 2011 and 2016 and comprising 1171 patients were included as follows: 545 (46%) patients had paroxysmal AF (pAF), 268 (23%) persistent AF (persAF) and 358 (31%) longstanding persistent AF (LSPAF). Fixed- and random-effect models were used to calculate the pooled overall freedom from atrial arrhythmias. The 1- and 2-year pooled overall antiarrhythmic drug (AAD) free (off-AAD) success rates were 78% (95% confidence interval (CI): 72-83%, n = 13) and 77% (95% CI: 64-86%, n = 6), respectively. The 1- and 2-year pooled on-AAD success rates were 84% (95% CI: 78-89%, n = 5) and 85% (95% CI: 78-90%, n = 3), respectively. Subanalysis regarding the different types of AF revealed a 1-year pooled off-AAD success rate of 81% (95% CI: 73-86%, n = 7) for pAF, 63% (95% CI: 57-69%, n = 5) for persAF and 67% (95% CI: 52-79%, n = 3) for LSPAF. The overall in-hospital complication rate was <3% (n = 36). We conclude that the TT-maze is an effective strategy for the treatment of AF with maintained efficacy at the 2-year follow-up. Furthermore, the TT-maze has demonstrated similar efficacy to the Cox Maze IV procedure at the midterm follow-up with a lower complication rate. Extended follow-up research is needed to determine whether the high success rates after TT-maze will be stable over time.