This study aimed to identify, by systematic review of the literature, whether intra-articular steroid injection before total joint replacement confers an increased risk of post-operative deep prosthetic infection. All studies assessing the incidence of deep prosthetic infection in patients who had undergone steroid injection in the same joint were included. A mixed meta-analysis and narrative review of 12 studies with 2068 participants was conducted. Steroid injection prior to total joint replacement was found to confer no increased risk of deep or superficial prosthetic infection (CI = 95%). We found no evidence of a link between injection and deep joint infection, and conclude that this is a safe procedure when conducted with aseptic precautions. We suggest a prospective randomised control trial to provide conclusive data on this question.