ObjectiveTo systematically review the impact of school breakfast on children's nutrition and health. MethodsThe PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the impact of school breakfast on children's nutrition and health from inception to June 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 8 RCT, involving 8 208 children were included. The results of meta-analysis showed that compared with non-school breakfast, the school breakfast could significantly improve the rate of school attendance (RR=1.38, 95%CI 1.26 to 1.51, P<0.000 1). However, there was no statistically significant difference in height, weight, weight-for-age, height for age, energy, protein, iron, or incidence of nutritional disease between the groups. ConclusionThe current evidence suggests that school breakfast has no impact on children's nutrition and health. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.