Purpose: Rotator cuff tendinopathy is associated with decreased function and restricted range of motion (ROM) of the shoulder. Hyaluronic acid(HA) injections have been used for the management and pain relief. The objective of this study is to compare the efficacy of HA with steroids, Placebo(normal saline), physical therapy, Lignocaine, PRP, and ESWT. Methods: PRISMA guidelines were followed for the literature search. The literature search was done on PubMed, Embase and Cochrane, using multiple search terms or derivatives until 20th March 2023. 18 RCTs meeting the eligibility criteria were included. Quality assessment was done using the Newcastle Ottawa score and GRADE criteria and risk assessment using risk of bias 2 tool. Quantitative analysis was done on VAS and constant murphy score whereas Qualitative analysis was done on ROM, DASH, UCLA and ASES. The follow-up period was up to 12 months. Results: Eighteen studies (1773 rotator cuffs) were pooled in the Systematic Review and Meta-analysis. GRADE assessment had high quality for VAS and Constant score. The Newcastle Ottawa Score ranged from 4 to 6. Significant improvement (p