Objective: PubMed, EMBASE, and Cochrane database were searched, from inception to January 2021, for publishedRWE studies reporting the procedural success rate for LAAO device implantation in patients with orwithout CKD. Two researchers independently screened search results and extracted data for studydetails (design, follow-up, assessment etc.), outcome results (procedure success rate), and conclusion.The quality of the included studies was assessed using Newcastle-Ottawa Scale (NOS) and random-effect model was used for meta-analysis. Methods: Of 65 articles identi?ed, four studies (2 from Germany, 1 from China, and 1 multinational) comprising 678CKD and 978 non-CKD patents receiving LAAO ful?lled the inclusion criteria. The majority (n= 3) of thestudies were of high quality. CKD was de?ned as an eGFR <60 ml/min per 1.73 m2 across studies. Threestudies reported procedural success rate as successful implantation and absence of signi?cant residualleak (≥5 mm). The mean age was above 70 years and Aamplatzer cardiac plug was used in most of theLAAO procedures (68%, n=1122), across studies. The meta-analysis showed a similar procedural successrate for LAAO procedure (CKD=98.4 and non-CKD=96.9) with a pooled risk difference of 0.01 [(95%CI:0.00-0.03), p=0.07]. Results: The procedural success rate of LAAO did not differ between the CKD and non-CKD patients. LAAOdemonstrated similar real-word procedural safety for patients with and without CKD. Conclusions: Objective: Percutaneous left atrial appendage occlusion (LAAO) devices are a therapeutic alternative used for theprevention of stroke in patients with atrial ?brillation (AF). Population with chronic kidney disease(CKD) are at high risk of procedural complications after transcatheter intervention; however, there is nometa-analysis on procedural success in CKD vs. non-CKD population receiving LAAO interventions. To perform a systematic review and meta-analysis of the real-world evidence (RWE) data on the procedure success ofLAAO in CKD population compared to the non-CKD population. Methods: PubMed, EMBASE, and Cochrane database were searched, from inception to January 2021, for publishedRWE studies reporting the procedural success rate for LAAO device implantation in patients with orwithout CKD. Two researchers independently screened search results and extracted data for studydetails (design, follow-up, assessment etc.), outcome results (procedure success rate), and conclusion.The quality of the included studies was assessed using Newcastle-Ottawa Scale (NOS) and random-effect model was used for meta-analysis. Results: Of 65 articles identi?ed, four studies (2 from Germany, 1 from China, and 1 multinational) comprising 678CKD and 978 non-CKD patents receiving LAAO ful?lled the inclusion criteria. The majority (n= 3) of thestudies were of high quality. CKD was de?ned as an eGFR <60 ml/min per 1.73 m2 across studies. Threestudies reported procedural success rate as successful implantation and absence of signi?cant residualleak (≥5 mm). The mean age was above 70 years and Aamplatzer cardiac plug was used in most of theLAAO procedures (68%, n=1122), across studies. The meta-analysis showed a similar procedural successrate for LAAO procedure (CKD=98.4 and non-CKD=96.9) with a pooled risk difference of 0.01 [(95%CI:0.00-0.03), p=0.07]. Conclusions: The procedural success rate of LAAO did not differ between the CKD and non-CKD patients. LAAOdemonstrated similar real-word procedural safety for patients with and without CKD.