Background: The efficacy of anti-adhesive barriers in preventing clinically significant adhesional small bowel obstruction (ASBO) in the paediatric population is poorly defined. This review evaluates the utility of anti-adhesive barriers in paediatric populations undergoing abdominopelvic surgery. Methods: A literature search was performed on Embase, Medline, Cochrane Central and the World Health Organisation (WHO) International Clinical Trials Registry Platform (ICTRP) on 20 August 2024. Our main outcome measures included ASBO, total complications, return to theatre and surgical site infection. Results: A total of 3 studies were included in this review, however 2 studies were published from the same group and institution. Separate analyses were performed due to potential for overlapping cohorts. Analysis of 2 studies involving 912 patients comparing anti-adhesive barriers (n=462) to control (n=440) suggested that anti-adhesive barriers reduced risk of ASBO compared with control (OR 0.39, 95% CI 0.19 – 0.84, p = 0.02). There is insufficient evidence to suggest that anti-adhesive barriers were superior to control in reducing overall postoperative complications (OR 0.81, 95% CI 0.41 – 1.58, p = 0.63), surgical site infection (OR 0.95, 95% CI 0.35 – 2.57, p = 0.09). Conclusion: Anti-adhesive barriers may have a role in prevention of ASBO in paediatric populations undergoing open abdominopelvic surgery. However, this occurs on the background of moderate to high risk of bias, small sample size and high clinical heterogeneity with poor control for confounders. Further prospective research is required to further validate these effects.