The aim of this study was to conduct a systematic literature review with a subsequent meta-analysis on the technical complications and failures of removable partial denture (RPD) therapy in the moderately reduced dentition. A systematic literature search of established medical databases, last updated 06/2022, was conducted. RCTs and prospective and retrospective studies were included that had information on technical complications and failures of RPDs, at least 15 participants, an observation period of at least two years and a drop-out rate of less than 25%. Publications were selected on the title, abstract and full-text level by at least three of the participating authors. The evidence of the included studies was classified using the GRADE system. The bias risk was determined using the RoB2 tool and the ROBINS-I tool. Of 19,592 initial hits, 43 publications were included. Predominantly, retention of the prosthesis, retention loss of anchor crowns (decementations), fractures/repairs of frameworks, denture teeth, veneering or acrylic bases, and a need for relining were reported depending on prosthesis type and observation time. Focusing on technical complications and failures, only very heterogeneous data were found and publications with the highest quality level according to GRADE were scarce. Whenever possible, data on technical complications and failures should be reported separately when referencing the tooth, the prosthesis and the patient for comparability. Prostheses with differing anchorage types should be analyzed in different groups, as the respective complications and failures differ. A precise description of the kinds of complications and failures, as well as of the resulting follow-up treatment measures, should be given.