Sport related concussions (SRC) have become a significant concern and garnered increased attention in recent years due to the potential for long term problems in athletes (Kuhn et al., 2017). The 2017 Concussion in Sport Group defines SCR as a mild traumatic brain injury that is caused by a direct (e.g., blow to the face or head) or indirect (e.g., blow elsewhere on the body) force that is transmitted to the head (McCroy et al., 2017). Initial symptoms of concussion may include headaches, dizziness, vertigo, lack of awareness of surroundings, vomiting, and nausea. Due to a growing understanding of the negative outcomes of concussion, there has been an increase in the awareness (Beran & Scafide, 2022), identification (Cairo et al., 2022; Tsushima et al., 2019) and diagnosis (Davis et al., 2017) of SRC within the last decade. Consequently, there has also been an increase in the literature regarding the prevalence and incidence of SRC. As children and adolescents generally participate in sports more than adults (Eime et al., 2016), it is of no surprise that it is presumed that most SRC’s occur in youth populations. Despite this increased risk, there is still concern regarding the underreporting of concussions in youth sports (Chrisman et al., 2013; Ferdinand Pennock et al., 2020). Compared with adults, children and adolescents are more vulnerable to concussions because of a higher vulnerability of the developing brain, weaker neck muscles, and higher head to body ratio (Karlin, 2011). Further, the prefrontal cortex, which is the region of the brain that is responsible for executive functioning, is particularly vulnerable to injury in adolescent years (Grady, 2010). As a result, paediatric populations are known to experience serious short- and long-term symptoms of concussions that can have a significant impact on child development. This is no surprise given these concussive injuries are occurring during a critical period in a child's neurodevelopmental trajectory. Children and adolescents exposed to concussions may have their cognitive development impacted by experiencing fatigue, headaches, loss of concentration, and memory loss (Stojanovski et al., 2021; Wilmoth et al., 2019). In addition, concussive injuries in children may also lead to sleep disturbances, fine or motor skill impact, future limitations in physical activity, and vision and hearing challenges (Maerlender et al., 2020). These symptoms can consequently have a negative effect on a young person’s ability to learn and academic performance (Neelakantan et al., 2020). Concussions may also substantially impact young people’s emotional development, as seen in a recent literature review conducted by Gornall et al. (2021), which found that a third of children and adolescents develop a mental health problem after a concussion. This includes both internalising (e.g., withdrawing, anxiety, depression, and post-traumatic stress) and externalising problems (e.g., aggression, attention problems, and hyperactivity). Emotional changes resulting from a concussion can have a considerable effect on the relationships children share with their peers and family. Therefore, it is important to understand and acknowledge both the impact of the imminent symptoms following a child's concussion, as well as the longer-term symptoms and challenges that may potentially develop over time. Unfortunately, children who have had a previous history of concussion are at an increased risk of future concussion (Van Ierssel et al., 2021) and experiencing these reported negative symptoms for a prolonged period of time (Eisenberg et al., 2013). Additionally, children and adolescents often take a longer time to recover from concussions in comparison to adults (Davis et al., 2017), often requiring a more conservative approach to the management and return to sport or school (Purcell et al., 2019). Despite this increased risk and the research that suggests that youth sports have become increasingly more physically intense as competition heightens (Brenner, 2016; Post et al., 2017), there has been limited evaluation of concussion injury incidence in youth sports in comparison to the vast research and evaluation of professional adult athletes (Gardner et al., 2014; Nathanson et al., 2016; Prien et al., 2018; Ruhe et al., 2014). The most recent systematic review that investigated concussion incidence in youth populations across all sports was published by Pfister et al. in 2016, which investigated existing studies at the time that were published up to September 2014. The results showed that across 23 articles, 13 of which were included in the meta-analysis, the three sports with the highest concussion incidence rates were rugby, hockey, and American football. However, as noted by Pfister et al. (2016), they were not able to provide any findings relating to age or gender. Alternatively, a systematic review and meta-analyses conducted by Cheng et al. (2019) explored sex-based differences of incidence rates of concussions across individuals aged 10 years and older. The results of this review suggested that engagement in soccer and basketball demonstrated a significantly higher incidence of concussions in females in comparison to males. There has also been a review published that specifically focused on the incidence of concussion within action sports only (Feletti & Bonato, 2020). However, with almost a decade of literature since the Pfister et al. (2016) was published, there is a need for an updated review that considers all historically and recently published research across all sports in youth athletes. Given the increased risk and growing concern for young athletes, an understanding and awareness of the updated incidence of concussions amongst youth across sports would be able to assist physicians in developing strategies and guidelines for the treatment of youth athletes. Additionally, this research would be able to assist healthcare providers, coaches, parents, and the wider community in acknowledging the level of risk of concussion, so that adequate measures can be put in place to reduce this risk. These adequate measures could also consider the potential differences that may be found across sports, ages, and gender. Since the previous Pfister et al. (2016) systematic review and meta-analysis investigating incidence rates of concussion in all youth sports, there has been an acceleration in SRC research. Therefore, an updated review of evidence is required. Further to this, an updated review will provide a better understanding of concussion incidence according to factors such as sport type, gender, and age. The primary goal of this systematic review and meta-analysis is to investigate the incidence of concussion in children and adolescents (≤ 18-years-old) engaging in sports and to assess how the incidence of concussion differs across different sport types, gender, and age. The results of this review will continue to inform intervention monitoring, guideline development, and player safety.