Background The achievement of optimal results out of total knee arthroplasty surgery depends on fit and sizing of the implant over the bone. Mismatch between resected bone and implant alters the outcome of the surgery. Identifying the medial-lateral and anterior–posterior measurement in the resected femur lays the foundation for identifying the implant size. The ratio of medial-lateral and anterior–posterior measurement figures out the match between implant and bone. The bony architecture is influenced by ethnicity. Therefore it becomes essential to study distal bone notability from different indigenous origin groups. Questions/purposes This study incorporates a systematic review analysis of the English literature published on the anthropometric dimensions of the distal femur. The anterior–posterior and medial-lateral width values are assessed to determine the inherent ethnic differences in bony parameters. Methods An extensive search in seven search engines was performed to produce 9820 responses. This collection was imported in endnote library to finally obtain 6320 publications after duplication. Further detailed examination produced only 65 papers to undergo full-text inspection. After a thorough review of the full text, only 20 papers were found to be relevant for a systematic review. Results There were 8 different racial populations assessed in the various studies. Caucasians were studied by most of the authors. All papers imply the need of alterations in the current implant sizing to improve fitment in Asian population. Conclusions Most of the studies were performed with patients of Caucasian origin. The Asian sub-populations studies demonstrated the incongruence in implant sizing and anthropometric measures and therefore recommending that these ethnic differences need to be addressed in future implant design.