Purpose: The aim of this study was to assess the efficacy of alveolar vertical distraction osteogenesis and autogenous bone grafting in terms of bone gain, bone resorption, and implant survival and success rates and investigate the relationship between bone gain and resorption after alveolar vertical distraction osteogenesis. Materials and Methods: A systematic search was done using MEDLINE, EMBASE, the Cochrane Library, and KoreaMed from inception to April 30, 2014. Supplementary manual searches of published full-text articles were also performed. Results: Searches of four electronic databases and manual searches resulted in 1,538 articles. After selection, four studies were included in the systematic review and meta-analysis. The difference in bone gain at the end of distraction or bone grafting was statistically significant (weighted mean difference [WMD] 1.86, 95% CI 0.03 to 3.69, P = .05; heterogeneity: I2 = 78%, P = .01). However, there was not a statistically significant difference between alveolar distraction osteogenesis and onlay bone grafting (WMD 0.30, 95% CI -0.99 to 1.59, P = .065). Bone resorption between the end of treatment and the time of implant placement was not statistically significant (WMD -0.12, 95% CI -1.10 to 0.85, P = .80; heterogeneity: I2 = 78%, P = .01). A simple equation related to bone gain and resorption after alveolar vertical distraction was induced from these results. Conclusion: There was not a statistically significant difference between alveolar distraction osteogenesis and onlay bone grafting in terms of bone gain and bone resorption. Keywords: alveolar vertical distraction osteogenesis, autogenous bone graft, bone gain, bone resorption, meta-analysis