INTRODUCTION Radiotherapy is used with increasing frequency after breast reconstruction in patients with locally advanced breast cancer or with metastases in axillary lymph nodes. However, it has been proposed that there could be differences in the effectiveness and safety of post-reconstruction radiotherapy depending on what type of breast reconstruction is used, be it autologous or prosthetic reconstruction. METHODS To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by searching multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, reanalyzed data from the primary studies, performed a meta-analysis, and prepared a summary table of results using the GRADE method. RESULTS AND CONCLUSIONS We identified five systematic reviews that together included nine primary studies, all of which correspond to observational studies. We conclude that autologous breast reconstruction could decrease reoperations attributed to general complications compared to prosthetic breast reconstruction in patients undergoing post-reconstruction radiotherapy, but it probably increases the risk of skin or flap necrosis. It is not clear if there are differences in other outcomes, as the certainty of the evidence has been assessed as very low.