This systematic review and meta-analysis included 18 studies consisting of 956 patients with oropharyngeal cancer (OPC) treated with PRT. The pooled rates of acute grade 3+ toxicities were as follows: dermatitis 19%, mucositis 32%, xerostomia 1.3%, dysphagia 13%, and weight loss 1.4%. The pooled rate of acute hospitalizations was 10%. Compared to IMRT, PRT was associated with lower rates of acute feeding tube use (21% versus 31%; P = 0.0012), but not long-term feeding tube use (1.4% versus 2.7%; P = 0.24). The OS at 2- and 3-year were 98% and 96%, while PFS of 93% and 86%. Oncologic outcomes associated with PRT appear to be similar to those reported in prospective studies of IMRT e.g. reported 2-year OS rate of 97.3% and PFS of 87.6%. PRT for patients with OPC is associated with favorable toxicity outcomes.