Speed is a key determinant of crash risk and injury severity, particularly on urban and secondary roads with frequent interactions between vulnerable road users. Traffic calming measures (TCMs) encompass physical, regulatory, perceptual, and technological interventions and aim to reduce operating speeds and improve safety and liveability. This study systematically evaluates the effectiveness of TCMs in reducing speed and improving safety outcomes on urban roads, following PRISMA 2020 guidelines. It encompasses the identification, screening, and synthesis of articles from the Scopus, ScienceDirect, and SpringerLink databases, published between January 2020 and February 2026. Risk of bias in the included studies was assessed qualitatively by the co-authors. The assessment was conducted independently, with discrepancies resolved through discussion. A total of 91 studies were included in the review. Evidence from field studies, driving simulator experiments, and analytical, simulation, and computation-based evaluations is reviewed and structured within a three-cluster taxonomy comprising physical and geometrical measures, regulatory and perceptual interventions, and digital and technological approaches. The synthesis indicates that physically self-enforcing measures yield the most consistent reductions in speed. At the same time, regulatory and digital interventions can deliver meaningful safety benefits when implemented at scale with credible governance. Perceptual and advisory measures show more varying and context-dependent effects. The evidence base is limited by heterogeneity in study designs, short-term evaluations, and inconsistent reporting across studies.