Background Smoking cigarettes negatively impacts ovarian reserve and fertility but less is known about the impact of vaping (e-cigarette use). Objectives The aim of this systematic review was to assess the impact of vaping on ovarian reserve and outcomes of assisted reproductive technology (ART). Search Strategy A systematic search of PubMed, the Cochrane database, EMBASE and CINAHL and selected conference abstracts from 2019-2025 was carried out using relevant search terms. Selection Criteria We included experimental and observational studies with human female participants. Vaping was the exposure. Objectively measured ovarian reserve markers and results of ART were outcomes. Studies of animals, males only or pregnant women and review/opinion articles were excluded. Data Collection and Analysis PRISMA guidelines were followed, and studies were assessed with a risk of bias tool. Main Results The initial search yielded 213 articles; three studies met the inclusion criteria. One retrospective review of > 20,000 healthy women of reproductive age and observed a 7.76% reduction in Anti-Müllerian hormone (AMH) levels in vapers compared to non-vapers . Two prospective observational studies on outcomes of intracytoplasmic sperm injection (ICSI) for infertile couples, compared smokers/vapers to non-smokers. One study reported significantly lower AMH levels and fertilisation rates in smokers/vapers but neither study reported a difference in clinical outcomes. Conclusions Vaping appears to reduce ovarian reserve, but it is yet to be empirically proven whether vaping negatively impacts ART outcomes. Funding No funding was provided to carry out this systematic review.