Background: Macular edema (ME) is an ocular condition resulting from the accumulation of fluid in the central, most visually important part of the retina, typically as a complication of a retinal or inflammatory disease. Traditionally, laser photocoagulation or intravitreal injections of corticosteroids or anti-vascular endothelial growth factor agents are used to treat ME. However, these treatment options may have a wide array of undesirable side effects or limitations in their usage. In ophthalmology, topical NSAIDs are already largely used for their potent inhibition of inflammatory processes and treatment of postoperative ME. The overall diversity of NSAID agents, their mechanism of action, and risk profile make them a viable alternative option for intravitreal administration. This study sought to present a narrative synthesis and meta-analysis on the efficacy and safety of intravitreal injections of NSAIDs for the treatment of macular edema. Methods A systematic search was conducted in the PubMed, Embase, Springer, and Cochrane Library databases, with search terms such as ('cystoid macular edema' OR 'cme' OR 'macular edema' OR 'macula cystoid edema') AND ('intravitreal injection' OR 'intraocular injection' OR 'intra-ocular injection') AND ('non-steroid anti-inflammatory agent' OR 'nsaid' OR 'non-steroidal anti-inflammatory drug' OR 'diclofenac' OR 'ketorolac' OR 'bromfenac' OR 'nepafenac' OR 'flurbiprofen') in KEYWORDS and FULL-TEXT on April 4, 2025. Relevant randomized and non-randomized clinical trials and observational studies were included if they involved intravitreal NSAID administration. Risk of bias and certainty were assessed. Data was extracted and evaluated using either narrative synthesis or meta-analysis, depending on the available data. Studies missing data for average best-corrected visual acuity and central macular thickness (CMT) were excluded from the meta-analysis. Results Eight total studies, including six randomized and two nonrandomized trials, reporting 313 subjects and 340 eyes were included. All eight studies validated the safety of intravitreal NSAID agents. Two studies indicated intraocular pressure (IOP) reduction following administration, while others reported no significant IOP changes. Meta-analysis of 110 eyes found nonsignificant functional visual recovery (p=0.07), while meta-analysis of 130 eyes revealed significant reductions in CMT and anatomical improvement (p=0.04). Risk of bias and certainty assessment suggested potential effects of publication bias in the results. Conclusion Intravitreal NSAID treatments for ME were not associated with any adverse reactions. Comparatively, they show insignificant functional gain but significant structural improvement. Although there is uncertain evidence of their efficacy, intravitreal NSAIDs present a viable alternative to current treatment methods and require further investigation in ME management.