Aims This literature review aims to assess and summarise current knowledge on the growth rates of craniofacial fibrous dysplasia (FD), focusing on how factors such as age, lesion location, and hormonal influences impact progression. This review seeks to inform clinical guidelines and provide a foundation for individualised monitoring and treatment strategies. Methods We conducted a systematic review of the literature using PRISMA guidelines with keywords related to craniofacial fibrous dysplasia, growth rates, anatomical influence, and hormonal impact. Studies published between 1997 and 2023 were included if they provided quantitative data on FD growth rates or analysed factors influencing growth progression. Heterogeneity prevented meta-analysis. The QUADAS-2 tool was used to assess risk-of-bias. Results After exclusions, 32 studies were identified, encompassing data on over 1,500 patients with craniofacial fibrous dysplasia. Analysis revealed that FD growth rates peak in childhood and adolescence, with annual rates commonly reaching 20-30%, before decelerating in adulthood to under 5% per year. Studies consistently showed stabilisation in growth post-puberty, though exceptions exist. Lesions located in high-stress or hormonally influenced areas, such as the skull base and maxilla, exhibited faster growth rates, with some adult cases continuing at 3-7% per year. Hormonal influences, including elevated growth hormone and estrogen levels, were shown to prolong FD activity, particularly in polyostotic cases. Conclusion The growth rate of craniofacial FD generally decreases with age but is subject to variability based on anatomical location and hormonal factors. Most adult cases demonstrate stabilisation, though select cases show ongoing growth. These findings highlight the importance of individualised follow-up, with implications for treatment planning and patient counselling. Further longitudinal research is needed to refine growth rate estimates and develop more tailored clinical guidelines for FD management.