This paper presents a comprehensive review of scientific papers and market reports analyzing the economic competitiveness of fuel cell electric buses (FCEBs) with respect to their conventional alternatives via the total cost of ownership (TCO) methodology. We discussed the variables and data taken into account and compared the resulting outcomes by year and geographical areas. It emerged that FCBs are not currently cost competitive. The decreasing trend in acquisition and fuel costs, however, indicates potential for future competitiveness. We find that the current TCO literature on FCEBs presents several areas of uncertainty and weakness. Potential improvements can be achieved by: (i) extending the geographic coverage to Asian and African developing countries; (ii) making use of real-world data instead of simulated data, in particular, concerning acquisition costs, hydrogen costs under different pathways, fuel efficiency, and maintenance costs; (iii) clarifying the role of infrastructural costs; (iv) exploring the existence of economies of scale at fleet level; (v) distinguishing among different bus sizes.