Background We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflam-matory syndrome in pediatrics diagnosed during the COVID-19 pandemic.Data sources A literature search in Web of Science,PubMed,Scopus,and Science Direct was made up to June 29,2020.Results Analysis of 15 articles(318 COVID-19 patients)revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics,Kawasaki-like features as fever(82.4％),polymorphous maculopapular exanthema(63.7％),oral mucosal changes(58.1％),conjunctival injections(56.0％),edematous extremities(40.7％),and cervical lymphadenopathy(28.5％),atypical gastrointestinal(79.4％)and neurocognitive symptoms(31.8％)were also com-mon.They had elevated serum lactic acid dehydrogenase,D-dimer,C-reactive protein,procalcitonin,interleukin-6,troponin I levels,and lymphopenia.Nearly 77.0％developed hypotension,and 68.1％went into shock,while 41.1％had acute kidney injury.Intensive care was needed in 73.7％of cases;13.2％were intubated,and 37.9％required mechanical ventilation.Intravenous immunoglobulins and steroids were given in 87.7％and 56.9％of the patients,respectively,and anticoagulants were utilized in 67.0％.Pediatric patients were discharged after a hospital stay of 6.77 days on average(95％CI 4.93-8.6).Conclusions Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at risk.Monitoring cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.