Background: Lingual orthodontic appliances and clear aligner therapy have been the treatment of choice for patients with primary concern of aesthetics throughout the treatment. There are no systematic reviews comparing the adverse effects and treatment duration of the two aesthetic options available in orthodontic therapy. Aim: The aim of this study was to systematically review the evidence available regarding the adverse effects and treatment duration of Lingual Orthodontic treatment and that of Clear aligner therapy Materials and Methods: Data was collected from the year 2010 to 2020 that satisfied the inclusion and exclusion criteria, it was analysed for characteristics and quality assessment for the same was carried out. Results: The most common adverse effects of lingual orthodontic appliances include tongue pain, chewing difficulties, and speech difficulties. In contrast, for clear aligner therapy, the most common adverse effects turned out to be poor occlusal contacts and root resorption. Whereas, treatment duration depends on the complexity of the case Conclusion: The data available is not enough to compare adverse effects and treatment duration of lingual orthodontic appliances and clear aligner therapy. Further studies are required to assess the same.