Background: Sclerotherapy with polidocanol is a minimally invasive treatment for smaller Aneurysmal bone cysts (ABCs), offering safety and lower recurrence rates compared to surgery. Treatment choice depends on ABC size and location, with denosumab and titanium elastic nails as alternatives. To our knowledge, there are no systematic reviews regarding sclerotherapy with polidocanol as a treatment for ABCs. We aim to elucidate the effects of polidocanol in patients with ABCs. Methods: This systematic review included studies involving patients with aneurysmal bone cyst treated with sclerotherapy using polidocanol as its agent. Literature search from database such as Pubmed, Cochrane, and Scopus resulted in 14 studies included in this review. Results: Multiple studies have examined the effectiveness of percutaneous sclerotherapy with polidocanol as a primary treatment for ABCs. Most studies favored this approach without comparisons, while some compared it to extended curettage or other methods. Results varied, with some showing successful healing and pain relief, while others noted minor complications. Sequential polidocanol instillations were found to reduce cyst volume and minimize recurrence. Other interventions, like absolute alcohol gel and Denosumab, showed potential but with varying outcomes. Conclusion: While percutaneous sclerotherapy with polidocanol has been prominently effective in managing aneurysmal bone cysts, further studies are required to identify the most effective and least invasive treatment strategies to optimize outcomes and minimize complications in clinical practice. © 2025 Delhi Orthopedic Association