Hemiarthoplasty is often considered in the setting of a preserved glenoid cartilage given the high risk of revision associated with TSA. Pyrocarbon (PyC) has been used as an implant that theoretically allows for formation of a neo-membrane which would act like cartilage to reduce glenoid wear. The purpose of this study is to evaluate the clinical outcomes, radiographic outcomes, revision, and complication rates in the existing literature on shoulder hemiathroplasty using PyC.MEDLINE, Embase, and Scopus were searched for articles relating to shoulder hemiarthroplasty using "pyrocarbon" or "pyrolytic carbon". Abstracts and articles were screened against predefined inclusion and exclusion criteria, with a minimum of 24-month follow-up required. Data on patient demographics, clinical outcomes scores, complications, revision rates, and radiographic findings was recorded. Where appropriate, meta-analyses was performed.Twelve studies were selected for final inclusion with a total of 536 patients. Of the studies reporting pre and postoperative range of motion, there was an overall improvement in ROM. The mean Constant score post op was 70.9 with a mean improvement of 36.2 points (n=359, 9 studies). Radiographically, 22.8% of patients (n=536, 8 studies) had evidence of glenoid erosion, 10.4% of patients had changes in implant positioning and 9.9% of patients had tuberosity thinning. 1.5% of patients had radiographic subacromial space reduction while 0.7% of patients had an increase in tuberosity thickness. Across all studies, there was an 8.6% complication rate with the most common cause being glenoid erosion (2.6%, n=14). There was an overall 7.7% revision rate (n=41) with 63% of the revisions being converted to a reverse/total shoulder arthroplasty (n=26).Pyrocarbon hemiathroplasty shows overall improvements in ROM and PROs for patients, there remains concern for glenoid erosion on radiographic evaluation at a minimum two year follow-up. Although preliminary studies have shown encouraging results, this systematic review emphasizes the need for longer term follow-up studies with further radiographic evaluation of severity of glenoid erosion and association with functional outcomes and failure risk.