ABSTRACT Objective To examine and synthesize the evidence regarding the effects of peer-based interventions on the leisure skills of children and youth from 3–21 years of age with neurodevelopmental disorders. Method A systematic review was conducted. Six databases were electronically searched, and 263 records were retrieved and evaluated using standard quality assessment criteria. Results Seventeen articles were included. Three main types of peer-based interventions were identified, peer mediated, peer networking, and peer mentored interventions. Conclusion There is strong evidence to suggest that peer mediated interventions, peer networking and peer mentored interventions can be beneficial for children and youth with neurodevelopmental disorders to increase their participation in social, leisure, and recreational activities and develop their play, social, and leisure skills, and enhance their physical and psychosocial health and quality of life.