Human activities introduce significant contamination into aquatic systems that impact biodiversity and ecosystem function. Many contaminants accumulate, and remediation options are now required worldwide. One method for bioremediation involves the application of macrofauna to stimulate microbial ecosystem processes including contaminant removal. However, if we are to confidently apply such a technique, we need clarity on the effect of bioturbators on different contaminants and how these vary under different environmental scenarios. Here we used a systematic review and meta-analysis to analyse current knowledge on the activities of bioturbating macrofauna in contaminated sediments and quantify how bioturbation-bioremediation changes depend on the taxonomic group, the aquatic ecosystem and important environmental variables. Three common contaminant classes were reviewed and analysed: metals, nutrients (i.e. ammonia and phosphorous)and polycyclic aromatic hydrocarbons (PAH). In addition, meta-regressions were calculated to estimate the effect of environmental and experimental design variables on effect sizes. Meta-analytic results revealed that deeper burrowing and more active sediment surface animals (e.g. polychaetes)increased metal release from sediments, nutrients and oxygen uptake by microbial fractions in comparison to bioturbators that inhabit shallower depths in sediments. In addition, there was a different effect of bioturbators on response variables in different aquatic systems. Finally, bioturbator effects on nutrient and metal release appeared modulated by context-specific variables such as temperature, pH, sediment grain size, animal density and experimental duration. Our findings highlight critical knowledge gaps such as field applications, less studied macrobenthic fauna and the incorporation of molecular approaches. Our results provide the first quantitative synthesis of the effects of bioturbators on contaminant fate and the variables that need to be considered for the optimization of this method as a viable approach for sediment remediation and contaminant management in aquatic systems.