Background: Systematic reviews (SR) should be up to date to maintain their importance in informing clinical practice and healthcare policy. However, little guidance is available about when and how to update SRs, and updating policies and practices of organizations are not clear. Objectives: To describe updating practices and policies of agencies that sponsor or conduct SRs. Methods: An Internet-based survey sampled an international group of 195 organizations within the SR community, including groups that conduct health technology assessments (HTAs) and clinical practice guidelines (CPGs). Results: The response rate was 65% (127/195) from across 26 countries, with 70% of participants identified as producers of SRs. Sole involvement in SRs was reported by 30% of groups. Further, 43% reported concurrent participation in SRs, HTA, and CPGs. The response rate of Cochrane reviews groups was 67%, and Cochrane affiliates constituted 27% of the sample. The importance of updating was rated as ‘high’ or ‘very high’ among 79% of organizations, with 57% reporting a formal policy for updating. However, when asked to elaborate on their policies, only 29% of organizations made reference to a written document, of which the Cochrane Handbook for Systematic Reviews of Interventions was cited most often (83%). Over half of respondents reported that more than 50% of their respective SRs were likely to be out of date. Authors of original SRs (40%) were deemed most responsible for ensuring SRs were current. Barriers to updating included resource constraints, reviewer motivation, lack of academic credit, and limited publishing formats. A large portion of respondents (70%) indicated they ‘somewhat’ or ‘strongly’ support centralizing updating efforts across institutions or agencies. Further, 84% of respondents indicated they ‘somewhat’ or ‘strongly’ favoured the development of a central registry of SRs, analogous to efforts within the clinical trials community, in order to coordinate updating activities across agencies and review groups. Conclusions: The survey data indicate that most organizations that sponsor and/or carry out SRs consider updating as important. Despite this recognition, several organizations reported not having formal policy in place for updating previous SRs. Centralizing efforts for updating should be considered and may include a central registry of SRs.