Introduction Retroperitoneal trauma is associated with high morbidity and mortality, particularly if the vena cava (VC) is involved. Resuscitative endovascular balloon occlusion of the VC (REBOVC) can limit life-threatening bleeding however there is a paucity of published data. The aim of this systematic review was to summarise the literature on REBOVC, describe common techniques and assess its safety/utility in retroperitoneal trauma. Methods A systematic review of the literature was undertaken according to PRISMA guidelines. Eligible studies were animal models of REBOVC, and any studies involving humans undergoing REBOVC. Reference lists of included studies were searched to identify other potentially relevant studies. Results Ten studies were eligible for inclusion. Five described REBOVC in humans (three case reports and two case series), totalling 12 patients. Injuries were mostly penetrating (gun-shot wounds [n = 7], stabbing [n = 3]) followed by blunt trauma (n = 2). Method of venous access was either direct (via a VC defect) or percutaneous. Older studies described the use of foley catheters for occlusion and newer studies described hybrid techniques utilising specialised occlusive balloons. Almost all (n = 11/12) patients survived their injury and were discharged from hospital. Five experimental animal studies used porcine models of VC trauma, demonstrating improved outcomes in those animals treated with REBOVC; with prolonged time to death and reduced blood loss. Conclusion REBOVC appears to be effective in pre-clinical animal studies at controlling haemorrhage and prolonging life. While the evidence base is small for use in humans, we posit REBOVC can be used in appropriately selected patients with good outcomes.