This study aimed to systematically review studies on the effect of peer tutoring on pediatric nursing education for nursing students and identify its contents and characteristics. A comprehensive search was conducted from November to December 2023 across databases including PubMed, Embase, CENTRAL, CINAHL, ProQuest, and others. We included both published and unpublished literature in English or Korean. Three reviewers independently screened and selected eligible studies that involved undergraduate nursing students participating in peer tutoring programs focused on pediatric nursing education. We analyzed quantitative outcomes related to learning effects and learner responses. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials and the risk of bias assessment tool for non-randomized studies. Five studies were reviewed, encompassing randomized controlled trials, a non-randomized controlled trial, a cohort study, and a before-after study. These interventions were conducted in school settings or pediatric clinical environments and featured different forms of peer teaching: horizontal, near-peer, and reciprocal. The tutor-to-tutee ratios ranged from 1:3 to 1:36.5. The educational content covered nursing care for major neonatal diseases, communication skills, medication administration, and resuscitation techniques. Significant improvements in cognitive knowledge and communication skills were observed among nursing students. However, there was noticeable variability in the design and reporting of the studies. Peer tutoring programs can effectively enhance pediatric nursing education by improving nursing students' knowledge and skills. For future meta-analyses, more studies in this field reported according to reporting guidelines are needed.