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Background: Psychological factors have been proven to influence the outcomes as well as overall recovery following an elective orthopedic arthroplasty. However, current practice of elective orthopedic surgeries does not routinely include psychological interventions. Objective: To determine if there is a correlation in patients with depression who undergo elective orthopedic arthroplasty having poorer surgical outcomes when compared to patients not diagnosed with depression. Methods: A systematic review was performed with an extensive literature search from December 2019 - January 2020 utilizing three electronic databases. Articles were included in the review if they were within the last 10 years, peer reviewed, full text article, human, English, and meeting inclusion criteria. Two researchers performed an independent and in-duplicate search and review process. After the final selection of articles, the researchers performed a data analysis, data extraction, quality assessment and qualitative analysis. Results: A total of 1,199 studies were identified through database searching. Six studies met all the inclusion criteria and were included in the quantitative synthesis. All studies showed the effect that mental health plays on overall outcomes of total joint arthroplasty patients. Patients with coexisting psychiatric diagnoses score lower in functionality and satisfaction postoperatively. Conclusion: A method and universal system should be constructed as well as studies in order to provide orthopedic providers to rate patient’s depressive symptoms and response to treatment. There is significant evidence in current literature regarding the impact of pre-existing mental health conditions on the outcomes of total arthroplasties. Future studies should be conducted to DEPRESSION AND TOTAL JOINT ARTHROPLASTY OUTCOMES v evaluate the need for psychosocial and socioeconomic factors outside of mental health conditions that may influence the patient’s overall outcomes.