Creatine is a widely studied ergogenic aid known for its effects on muscle performance and body composition. However, its impact or utility for athletes involved in combat sports, who often aim to reduce body mass to meet a specific weight class, remains unclear. To conduct a narrative systematic review of peer-reviewed published studies that examined the effects of creatine supplementation on body mass, body composition, muscular strength, power, endurance, fatigue, recovery, and cognitive performance in combat sport athletes. A comprehensive search was conducted in multiple public databases up to March 2025. Databases searched included PubMed, Scopus, Web of Science, and Google Scholar. Studies evaluating creatine supplementation in combat sports (eg wrestling, judo, taekwondo, boxing) were included. Outcomes assessed included changes in body mass and body composition, performance metrics, and markers of fatigue and recovery. Nineteen studies met the inclusion criteria. Creatine supplementation increased body mass, especially during longer-term interventions (≥6 wk) or when combined with structured resistance training. Creatine supplementation also increased measures of body mass and fat-free mass (FFM). Muscular power and maximal strength outcomes improved significantly after creatine supplementation, particularly in studies utilizing short-duration, high-intensity exercise protocols. Creatine supplementation did not influence measures of sport-specific endurance, recovery or fatigue. No serious adverse effects were reported across studies for creatine supplementation. Creatine supplementation enhances body mass, FFM, muscle strength and power in combat sport athletes. Given its safety and efficacy profile, creatine supplementation remains a promising supplement for supporting some aspects of athletic performance in combat sports.
