Background Chondroblastoma is a rare benign chondrogenic tumour of childhood and adolescence with recognised metastatic potential. Incidence, determinants of metastatic behaviour and evidence-based surveillance protocols remain poorly defined. Diagnostic criteria have evolved with molecular testing, particularly H3F3A/H3F3B mutation detection. Methods A systematic review of PubMed and related databases was performed. Studies required histological confirmation of primary tumour and metastases. Two reviewers independently screened studies and extracted demographic, tumour, molecular, metastatic, timing, management, and outcome data. Radiological and pathological reviews verified alignment with contemporary standards. Registered with PROSPERO (CRD420251133439). Results Twenty-five articles were identified. Five were excluded after radiopathological review for features inconsistent with contemporary diagnostic criteria, leaving 20 articles reporting 22 cases. Mean age at presentation was 27.9 years (9-57). Primary tumour locations included the ribcage (6/22), lower-limb long bones (6/22), pelvis (3/22), spine (2/22), tarsal bones (2/22) and humerus (1/22) with two unspecified. Mean maximum tumour dimension was 6.2 cm, with several tumours exceeding 8 cm. Metastases developed after a mean of 63.7 months (median 36; range 14-132); lung was the predominant metastatic site (16/22). Conclusion The confirmed metastatic chondroblastoma cases demonstrate atypical demographic and anatomical patterns compared with typical disease. Findings suggest biological heterogeneity among metastatic cases and limitations of relying on historical reports that may not reflect modern criteria. Surveillance strategies must balance cost and radiation exposure against the extreme rarity of metastasis. Knowledge of molecular markers may clarify tumour biology and help identify higher-risk primary disease warranting continued surveillance.