Purpose: Trapeziometacarpal (TMC) joint osteoarthritis (OA) is a common disabling condition. Current treatments do not have a significant impact on symptom relief or disease progression and the benefit of visco-supplementation remains uncertain. We aim to evaluate the efficacy of hyaluronic acid (HA) intra-articular injection in rhizarthrosis. Methods: A systematic review of the literature addressing the efficacy of HA on pain reduction, functional capacity or pinch strength in patients with rhizarthrosis was performed. Pain at rest, functional capacity and pinch strength were assessed at baseline, 4th, 12th and 24th weeks Results: Sixteen trials were included with a total of 587 patients treated with HA injections (9 randomized controlled trials (RCTs), 5 single-arm studies and 2 non-randomized comparative trials). Despite important heterogeneity among trials, HA injections lead to a reduction in pain at rest (decrease of 0.65-3.5 points and 0.8-4.03 points on Visual Analogue Score after 4th and 24th weeks respectively, compared to baseline). Regarding disability, as assessed by functional scales, all studies reported improvement on functionality. An increase in pinch strength of 0.1-1.4 kg and 0.4-2kg was also reported at 4th and 24th weeks respectively. Conclusion: HA injections can be a valid therapeutic option inducing remission of pain with improvement of functionality and strength in patients suffering from TMC joint AO.