The aim of the present study was to systematically review the existing literature on periodontal regenerative procedures in individuals affected by aggressive periodontitis (AgP). An electronic and manual search was performed using an ad hoc prepared search string. All types of study designs were considered acceptable for inclusion. Data about treated patients, baseline clinical parameters, type of surgery, and outcomes were extracted and recorded. A narrative evaluation of the results was performed. After the article-selection process, a total of 22 full-texts were included in the qualitative synthesis. Twelve papers were case reports; one was a retrospective study; six were non-randomized, comparative studies; and three papers were published on two randomized, controlled trials (RCT). Various biomaterials and surgical techniques were described in the included papers. Based on the existing literature, even considering the relatively low level of evidence, periodontal regenerative surgery could be successfully performed in patients affected by AgP. There is a substantial need of high-quality RCT to support this.