Abstract: We searched Embase, PubMed and the Cochrane Library for randomized or quasi‐randomized controlled trials to compare the use of single‐balloon to double‐balloon catheters. The risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) was calculated using fixed‐effects or random‐effects models. Four studies involving a total of 793 pregnant women were included. There were no significant differences in the rate of cesarean (RR 1.09, 95% CI 0.86, 1.38; P = 0.48), or vaginal deliveries within 24 h (RR 0.94, 95% CI 0.82, 1.09; P = 0.42), the mean time to delivery (MD 0.39, 95% CI −0.90, 1.68 h; P = 0.55) or Bishop score improvement (MD 0.62, 95%CI −0.18, 1.42; P = 0.13) between the groups. Women who received the double‐balloon catheter had a similar risk of maternal intrapartum fever and post‐partum hemorrhage. Pain during ripening was only reported in one trial and was significantly higher with the double balloon, whereas pain during device insertion was measured in two trials: one reported no difference while the other reported significantly increased pain with the double balloon. The double‐balloon and single‐balloon (Foley) catheters had similar effectiveness and safety. The Foley catheter is significantly cheaper, widely available and accessible, has a longer history of use and remains the logical choice over the double‐balloon catheter for cervical ripening. [ABSTRACT FROM AUTHOR]