Introduction: Rigid Gas permeable (GP) lenses are widely used for vision correction, but their long-term effects on the corneal endothelium remain uncertain. This systematic review and meta-analysis aimed to evaluate the impact of GP lens wear on corneal endothelial cell density, morphology, and function. Methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library identified cohort and case-control studies reporting endothelial cell density, morphology, and pleomorphism in individuals wearing GP lenses for over six months. Two reviewers independently extracted data, and the NewcastleOttawa Scale was used to assess bias risk. A random-effects model meta-analysis calculated pooled estimates of GP lenses' effects on endothelial parameters. Results: Meta-analysis comparing GP lenses to controls revealed no significant differences in endothelial parameters. For endothelial cell density, the mean difference was 4.40 (p = 0.207, Confidence Interval (CI): -2.43 to 11.24, I² = 99.62%). Endothelial coefficient of variation (ECV%) showed a mean difference of -5.60 (p = 0.245, CI: -15.03 to 3.84, I² = 99.77%), while endothelial hexagonality (HXG%) had a mean difference of -3.15 (p = 0.190, CI: -11.26 to 4.96, I² = 97.45%). Substantial heterogeneity across studies limits definitive conclusions. Conclusion: GP lenses do not significantly impact corneal endothelial parameters, including ECD, ECV%, and HXG%, compared to controls. Further research is required to validate these findings and assess long-term effects on endothelial integrity.