The addition of calcium carbonate to catchments or watercourses – liming – has been used widely to mitigate freshwater acidification but the abatement of acidifying emissions has led to questions about its effectiveness and necessity. We conducted a systematic review and meta-analysis of the impact of liming streams and rivers on two key groups of river organisms: fish and invertebrates. On average, liming increased the abundance and richness of acid-sensitive invertebrates and increased overall fish abundance, but benefits were variable and not guaranteed in all rivers. Where B-A-C-I designs (before-after-control-impact) were used to reduce bias, there was evidence that liming decreased overall invertebrate abundance. This systematic review indicates that liming has the potential to mitigate the symptoms of acidification in some instances, but effects are mixed. Future studies should use robust designs to isolate recovery due to liming from decreasing acid deposition, and assess factors affecting liming outcomes.