Refill Friction Stir Spot Welding (refill FSSW) is a method for joining similar and dissimilar lightweight metallic materials or thermoplastic polymers. The technique produces welds that feature suitable mechanical properties with advantages such as the possibility of industrial scalability and automation. Still, some challenges need to be overcome in order to increase the adoption of this technique in industry. Tool wear is a key issue for friction-based processes, since it impacts the process costs and quality of the welds. In this study, a total of 2350 welds of AA2198-T8 sheets were performed and the effect of wear on probe and shoulder was investigated. While the probe did not suffer any considerable wear after this number of welds, the shoulder underwent wear in different areas, with distinct wear mechanisms. Adhesive wear and plastic deformation were determined as the primary damage mechanisms affecting different areas of the shoulder. Mechanical testing of selected welds has shown a trend towards reduction in the lap shear strength (LSS) as a function of tool wear. Macrostructural analysis of welds' geometrical features shows that profile changes at the shoulder due to wear led to a trend of reduction in stirred zone area and, consequently, joints’ LSS. Modifications in the worn shoulder profile were suggested as possible causes for changes in hook height, which was identified as a further determining factor to the observed reduction in LSS. Still, all tested welds surpassed the minimum lap shear strength standard requirements for aeronautical applications.