Purpose: To evaluate the outcomes of osteo-odonto-keratoprosthesis (OOKP) procedures performed in India and assess anatomical retention, visual improvement, and postoperative complications. Methods: A systematic literature search of PubMed, Scopus, IndMed, and Google Scholar was performed up to March 2025. Studies reporting clinical outcomes of OOKP in Indian patients were included. The PRISMA guidelines were followed. Primary outcomes were anatomical retention and improvement in best-corrected visual acuity (BCVA). Results: Six studies met the inclusion criteria, encompassing 217 patients. The most common indications were Stevens-Johnson Syndrome (42%), chemical burns (27%), and mucous membrane pemphigoid (14%). Anatomical retention rates ranged from 70% to 95%. Visual improvement to ≥20/200 was noted in 68%–85% of cases. Major complications included glaucoma (15–33%), laminar resorption (10–25%), and mucosal necrosis (up to 20%). Conclusion: OOKP offers a viable solution for end-stage corneal blindness in Indian patients, yielding favorable visual and anatomical outcomes. High complication rates and limited accessibility necessitate further innovation and policy-level interventions.