Objective: Soccer match-play is typically contested over 90 min; however, in some cup and tournament scenarios, when matches are tied, they proceed to an additional 30 min, which is termed “extra-time” (ET). This systematic review sought to appraise the literature available on 120-min of soccer-specific exercise, with a view to identifying practical recommendations and future research opportunities. Methods: The review was conducted according to the PRISMA guidelines. Independent researchers performed a systematic search of PubMed, CINAHL and PsycINFO in May 2019, with the following keywords entered in various combinations: “soccer”, “football”, “extra-time”, “extra time”, “120 minutes”, “120 min” “additional 30 minutes”, and “additional 30 min.” Results: The search yielded an initial 73 articles. Following the screening process, 11 articles were accepted for analyses. Articles were subsequently organized into the following 5 categories: movement demands of ET, performance responses to ET, physiological and neuromuscular response Pluralize response (i.e., responses) during ET, nutritional interventions, and recovery and ET. The results highlighted that during competitive match-play, players cover 5%–12% less distance relative to match duration (i.e., meters per minute) during ET compared to the preceding 90 min. Reductions in technical performance (i.e., shot speed, number of passes and dribbles) were also observed during ET. Additionally, carbohydrate provision may attenuate and improve dribbling performance during ET. Moreover, objective and subjective measures of recovery may be further compromised following ET when compared to 90 min. Conclusion: Additional investigations are warranted to further substantiate these findings and identify interventions to improve performance during ET.