Objective: Common methods for matching tooth shade can be classified into two categories: visual and instrumental measurements. This systematic review evaluated these two methods in terms of precision and accuracy using the agreement percentage rate. Method and Materials: The following databases were searched for studies comparing different shade-matching methods: MEDLINE (PubMed), Embase, and Google Scholar. Reference lists of relevant articles were also searched. Screening, data abstraction, and quality assessment were conducted independently and in duplicate. Results: Twenty-six studies were included. Seventeen studies provided data on the precision of the evaluated shade-matching methods, eight provided data on accuracy, and one provided data on both precision and accuracy. Conclusion: Instrumental measurements using a spectrophotometer may provide the most precise and accurate shade-matching outcomes. However, the limitations of the available articles suggest that high-quality studies are still needed verify this claim. Keywords: colorimeter, digital imaging, shade matching, spectrophotometer, visual