Study design: A literature review. Background: The bodyweight of the prosthetic user is supported and distributed by the prosthetic socket during the stance phase of gait. Throughout swing phase, inertial forces (pressure and shear) are exerted by the socket suspension-mechanism onto the residuum to facilitate suspension. Objectives: To identify and investigate available evidence in Trans-Tibial (TT) socket design and suspension to highlight the most effective weight transfer mechanisms and suspension techniques. Methods: A literature research was conducted comprising two parts: socket design and suspension. Boolean search terms and truncation were used using relevant keywords in online search engines to obtain precise results. Results: 17 papers which met inclusion criteria were reviewed. Conclusions: A conclusion on whether socket preference is due to the suspensionmechanism or socket design itself cannot be drawn. PTB sockets are still successfully used and in some studies preferred over TSB. Biomechanically, however, TSB sockets allow for a more even weight-distribution when combined with suction, particularly VASS. Some limited evidence exists to support that such designs may have some effect on wound healing and early ambulation. Further research must be conducted to standardise acclimation periods. Crossover randomised controlled trials (RCT) with larger sample sizes are required to establish an evidence base to improve clinical practice.