The aim of this study is to understand the phenomenon of e-learning in orthodontic graduate education. The study has assessed e-learning based on two objectives, with the primary objective, summarising the outcomes and implications of e-learning over other forms of learning. The outcomes have been further discussed under primary and secondary measures. The secondary objective was to understand the impediments in the integration of technological advances in orthodontic educational instruction. The study conducted a comprehensive electronic search in the English language from January 1980 up to April 2019 on PubMed, Medline, EMBASE and Google Scholar. The search incorporated standard Boolean operators and keywords. The Problem/Patient/Population, Intervention, Comparison or Control, and Outcome (PICO) criteria were applied in the selection of reviewed articles. Pre-set inclusion and exclusion criteria were followed for article selection. Following the above-mentioned parameters, a total of twenty-one studies met the inclusion criteria with seventeen studies measuring the primary outcome of knowledge and skill gain. Twelve studies assessing the secondary outcome comprised of students' attitudes towards e-learning instructions. All the twenty-one studies provided an understanding on the methods employed and content delivered through computer assisted learning. Overall, knowledge gain and student's attitudes were found to be positive following e-learning. However, more e-learning programs and learning environments with interactive experiences must be developed and tested to fully understand the effects these systems offer. The review, in addition, has highlighted the implications and impediments of technology-assisted learning with a proposed step-wise approach in overcoming these challenges. The review concludes with a brief introduction into a new concept of smart learning environment.