Background and Objectives: The retroauricular hairline approach is increasingly being used for submandibular gland resections because of the excellent cosmetic results. A meta-analysis of studies compared the retroauricular hairline and conventional approaches for submandibular gland excision. Methods: A meta-analysis of studies identified from the PubMed, Embase, and China National Knowledge Infrastructure databases was performed. Postoperative nerve damage (temporary earlobe numbness and other signs of nerve damage), surgical durations, wound lengths, intraoperative bleeding volumes, postoperative drainage, and lengths of hospital stay were compared. Results: The retroauricular hairline approach led to greater risk of temporary earlobe numbness (OR: 7.28; 95% CI: 1.57–33.87; P = 0.01), but this resolved during the follow-up. There was no significant difference in the risk of other nerve injuries between the two approaches. The retroauricular hairline group had significantly longer operative times and wound lengths compared to the conventional resection group. There were no significant differences between the two approaches in intraoperative bleeding volumes, postoperative drainage, and lengths of hospital stay. Conclusions: The retroauricular hairline approach is a safe and efficient alternative to the conventional approach. It provides better cosmetic results and does not increase the risk of long-term neurological complications.