<p>Renal osteodystrophy is a subset of chronic kidney disease mineral bone disorder which includes disorders of bone morphology associated with chronic kidney disease. Patients with renal osteodystrophy are at a higher risk of bone turnover abnormalities due to both the disease pathology and its treatment modalities. These trabecular changes lead to decreased bone density and thinning of cortical plates, making patients more susceptible to pathological fractures. Since surgical management is an integral part of dentistry, ranging from simple extractions to periodontal, endodontic, and trauma-related procedures, recognizing these abnormalities is crucial for effective patient care. One of the most common manifestations of this disease is brown tumors, which can present as painful swellings or lead to fractures, with the mandible being a frequent site of occurrence. Oral radiologists play a key role in identifying and managing these conditions. Early detection and intervention for facial skeletal changes due to renal osteopdytrophy are essential, as these alterations can become irreversible with disease progression, ultimately limiting dental treatment options. Proper management requires dental practitioners to be well-versed in both common and uncommon manifestations to ensure optimal care for affected patients. Understanding the impact of renal osteodystrophy on orofacial structures and function is imperative for comprehensive patient care as these manifestations can significantly affect patients’ oral health-related quality of life and may pose challenges for healthcare providers in diagnosis and management. This is a study protocol for a systematic review of case reports with an objective to comprehensively synthesize existing evidence about the orofacial manifestations in renal osteodystrophy patients. Inclusion criteria: Only case reports and case series of patients with chronic renal disease will be included for the review. No restrictions will be imposed on the country of publication, but only those published in the English language and humans will be included in the review. This systematic review will focus on case reports and case series, excluding experimental, case control, cohort, and narrative studies. The review will use the JBI methodology, including a comprehensive search strategy from MEDLINE, CINAHL, PsycINFO, SCOPUS, and Google Scholar databases. The data bases will be searched from their inception until February 2025. The study selection process will involve evaluating citations for eligibility using a title and abstract screening and full-text screening process, assessing methodological quality using the JBI critical appraisal checklist for case reports, and extracting data from papers using a customized data extraction tool by two independent reviewers. The data synthesis will involve pooling research outcomes using JBI SUMARI with the meta-aggregation approach, generating a set of oral manifestations observed in patients with renal osteodystrophy. Registered at Open Science framework: <a href="https://doi.org/10.17605/OSF.IO/9NAUF">https://doi.org/10.17605/OSF.IO/9NAUF</a>.</p>