Dengue is an arboviral infection that poses a substantial public health concern, with early diagnosis being a critical factor in effective management. However, limited diagnostic expertise in developing countries contributes to the under-reporting of dengue cases. This review compares the accuracy of rapid diagnostic tests (RDTs) and the tourniquet test (TT) in diagnosing dengue fever (DF) in non-laboratory-based settings. Relevant original articles on the use of RDTs and TT for dengue diagnosis were retrieved from PubMed, Scopus, and ScienceDirect. The STARD and QUADAS-2 tools were employed to evaluate the methodological quality of the included studies. Search terms included combinations of ‘fever’, ‘dengue’, and ‘“diagnosis’. In total, 23 articles were eligible for inclusion. The RDTs demonstrated mean sensitivities and specificities of 76.2% (SD = 13.8) and 91.5% (SD = 10.3), respectively, while the TT showed mean sensitivity and specificity values of 48.6% (SD = 24.9) and 79.5% (SD = 14.9), respectively. Overall, RDTs exhibited superior diagnostic performance compared to the TT. Our findings suggest that the TT is an inadequate stand-alone diagnostic tool for dengue. RDTs should be prioritized for dengue diagnosis in resource-limited settings. However, in situations where RDTs are unavailable, the TT may serve as a supplementary option.