Background: Neuropathic pain remains difficult to treat despite multiple pharmacological options. Cannabinoids have been proposed as therapeutic agents, yet the efficacy of oral formulations remains uncertain. Aim: The aim of this study was to evaluate the efficacy of oral cannabinoids in reducing pain intensity among patients with peripheral neuropathic pain through a systematic review and meta-analysis. Methods: This study employed systematic review and meta-analysis designed in accordance with PRISMA 2020 reporting guidelines. PubMed, ScienceDirect, Scopus, and IEEE Xplore were searched through January 2026. Randomized controlled trials evaluating oral cannabinoids for peripheral neuropathic pain were included. Pain intensity was standardized to a 0-10 scale and pooled using mean differences. Results: Four randomized controlled trials comprising 174 participants met inclusion criteria. Individual studies reported variable analgesic effects. Pooled analysis demonstrated no statistically significant reduction in pain intensity compared with placebo (Mean difference -057; 95% CI -1.26 to 0.12) Moderate heterogeneity was observed (I2= 74.4%). Conclusion: Current evidence does not support oral cannabinoids as first line therapy for peripheral neuropathic pain. Larger, methodologically rigorous trials are required to clarify their clinical role.
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