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Globally, there has been an increase in stringent regulations governing the use of chemical soil fumigants for controlling diseases, pests, and weeds. Grafting has been identified as an effective alternative to soil fumigation for managing soilborne diseases and pests in intensive vegetable cropping systems. The majority of watermelon (Citrullus lanatus) grafting research confirms that selected rootstocks play a role in improving plant resistance or tolerance to common soilborne diseases. Currently, there is a lack of evidence-based literature on the effects of grafting on watermelon fruit quality attributes and yield components. Previous reviews report wide variation in the impact of grafting on watermelon production, depending on rootstock-scion combinations and environmental conditions. This review employed evidence-based synthesis methods to comprehensively and methodically summarize research results of the impact of grafting on watermelon, with a focus on fruit quality and yield. In this systematic review, 548 citations (studies published during 2011-21) were screened against strict inclusion criteria, and data were extracted from 47 studies. Meta-analysis of percent differences between the grafted watermelon treatment and the nongrafted or self-grafted watermelon control was performed using extracted data of yield components and a wide range of fruit quality attributes. Meta-analysis of research data with variance measures was also conducted based on a rather limited number of studies. Our findings showed higher levels of total yield, average fruit weight, fruit length and width, fruit lycopene and soluble solids content, rind thickness, flesh firmness, lightness, chroma, and flesh nitrogen (N) content in grafted watermelon treatments compared with the nongrafted or self-grafted control. In particular, total yield, average fruit weight, and flesh firmness exhibited significant increases of a more than 10% difference. In contrast, grafted plants demonstrated decreases in fruit pH, hue angle, and flesh calcium content, although the reduction was not greater than 10% relative to the control. Meta-analysis of research data with variance measures further confirmed significantly greater total yield and flesh N content in grafted watermelon treatments compared with the nongrafted or self-grafted control. In addition, the meta-analysis results confirmed greater benefits of watermelon grafting in the presence of known soilborne disease pressure in contrast to the production scenarios without soilborne disease problems. [ABSTRACT FROM AUTHOR]