Background: The field of plastic surgery involves wounds, such as acute and chronic or non-healing wounds. The mortality and morbidity inflicted by wounds may be substantial. To enhance wound healing and decrease morbidity and mortality, wound dressing selection is critical. Hydrogel dressing is a modern dressing that is versatile for various clinical situations. Nevertheless, a hydrogel may be expensive and not always readily available. Since the Egyptian period, honey has been used as a dressing, which was suggested to have an antimicrobial, anti-inflammatory, and immunomodulatory effect. Aim: To compare hydrogel and honey as dressing for all types of wounds in terms of wound healing time and slough production. Method: We conducted literature searching in multiple online databases using the keywords "wound", "honey"or "honey dressing", "hydrogel"or "hydrogel dressing", "healing time", and "slough"or "necrotic tissue". Key terms were combined using Boolean operators and also searched using Medical Subheading (MeSH terms). Literature searches were conducted in the following databases; ProQuest, MEDLINE, Ebsco, EMBASE, Cochrane, Scopus, and Science Direct for randomized-controlled trial studies. Results: Literature searching yielded two randomized-controlled trials. Critical appraisal revealed that both studies were deemed valid. Honey dressing were similar to hydrogel dressing in terms of healing time 30.3 ± 6.7 (7-58) days vs. 33.2 ± 5.4 (14-61) days; 16.08 (12.3-19.9) days vs 17.12 (11.7-22.5) days; 17.13 (13.1-21.1) days vs 16.53 (12.3-20.8) days, respectively. However, Honey group has a slightly higher risk of slough production with an absolute risk increase of 4% for the non-HIV group and 3% for the combined group (HIV and non-HIV). Conclusion: The efficacy of honey as a wound dressing is equivalent to hydrogel for treating wounds in terms of wound healing duration. Nevertheless, the risk of slough production is slightly higher in the honey group.