Background This review identifies and describes clinical prioritisation tools used to rank patients on surgical waiting lists for cataract surgery, knee replacement, and inguinal hernia repair, and evaluate the effect of these tools on elective surgery waiting times.Methods We conducted a systematic review following Cochrane Rapid Review methods and PRISMA guidelines. Searches were performed in PubMed, Embase, and Google Scholar to identify studies evaluating prioritisation tools for cataract surgery, knee replacement, and inguinal hernia repair. We described the tools, their criteria and domains, assessed psychometric performance, and synthesised evidence on waiting-time outcomes. The certainty of the evidence was evaluated using GRADE methodology.Results Forty-six studies were included: 25 on cataract surgery, 19 on knee replacement, and 2 on inguinal hernia repair. Nine prioritisation tools were identified for cataract surgery, six for knee replacement, and two for inguinal hernia repair. Across the three procedures, identified tools incorporated multiple domains reflecting differences in clinical characteristics and disease burden. Evidence on psychometric performance and waiting-time effects was available only for cataract surgery and knee replacement and showed weak to moderate correlations with other tools. Evidence on the impact of prioritisation on waiting times was heterogeneous. Non-randomised studies showed weak associations between priority scores and surgical order, with longer waits for lower-priority patients in some settings. Modelling studies suggested either overall reductions in waiting times or reductions confined to high-priority patients.Conclusions Prioritisation tools adopt procedure-specific, multidimensional approaches, but evidence supporting their effectiveness in reducing waiting times is heterogeneous and, in some cases, uncertain.