ObjectiveTo conduct a scoping review of clinical evaluation studies on ultrasonic surgical systems (USS) published or registered since 2020, and to summarize the distribution of study types, evaluation domains, and reporting of device-use information. MethodsThe PubMed, Embase, Web of Science, Cochrane Library, Scopus, CNKI, WanFang Data, and VIP were searched. ClinicalTrials.gov and the Chinese Clinical Trial Registry were also searched. Studies published or registered from January 1, 2020 to April 15, 2026 were included. Two reviewers independently screened the literature and extracted data. Descriptive statistics were used for analysis. ResultsA total of 217 studies involving 28 261 participants were included, with a median sample size of 82. Randomized controlled trials were the most common study type, accounting for 102 studies (47.0%). Clinical effectiveness and safety were frequently reported, with reporting proportions of 98.2% and 90.8%, respectively. Technical performance and human factors were reported in 15.7% of the studies. A total of 101 studies (46.5%) described the use of USS in specific surgical steps or anatomical planes. In 114 studies (52.5%), only one or two evaluation domains were covered. Eighty-six studies (39.6%) did not report the specific device brand or model. Most studies compared USS with conventional instruments or electrocautery (147 studies, 67.7%), whereas comparisons with advanced bipolar energy devices were uncommon (5 studies, 2.3%). ConclusionClinical evaluation studies on USS have increased since 2020, but most remain focused on perioperative effectiveness and safety outcomes. Reporting of technical performance, human factors, device brand or model, and surgical task-scene information remains insufficient. Future studies should provide more detailed information on device configuration, operating parameters, surgeon experience, and specific surgical tasks to improve the interpretability of findings.