Productivity among small- and medium-scale tilapia farms varies considerably. The difference between the best performers and lower ones (yield gap), is affected by differences in growth rate and feed conversion ratio (FCR). FCR at the farm level is strongly influenced by survival of fish. In this study a systematic literature review of two databases (ASFA and CAB-Abstracts) identified 1973 potentially relevant articles. Data from 32 articles that met the inclusion criteria were analysed using linear mixed models for the most important factors with significant contributions to growth [investigated through analysis of the thermal growth coefficient (TGC)], survival and FCR of Nile tilapia. Increasing crude protein (CP), dissolved oxygen (DO) and pH significantly decreased FCR and increased TGC. Increasing stocking weight (SW) significantly improved both FCR and survival. Temperature had the largest effect on FCR followed by DO, pH and CP. DO had the largest effect on TGC followed by CP and pH. This study confirms that the optimal rearing temperature for Nile tilapia is between 27 and 32. Improving management to optimize DO (> 5 mg/L), stocking density (3–5 fish/ m2), SW (> 10 g) and CP (25 30%) will improve performance and survival in small- and medium-scale tilapia farming. However, it is hard to influence temperature in ponds and cages while DO is largely influenced by aeration. Since many small- and medium-sized farms do not have aeration, these major tilapia farming systems could benefit from genetically improved strains selected for resilience to highly fluctuating diurnal temperature and DO levels.