Objective: To evaluated the efficacy of Pediatric Tuina in treating upper respiratory tract infections (URTIs) for children. Method:We conducted a systematic search of 9 electronic databases from establishment to September 2023. All published randomized controlled trials (RCTs) focused on the efficacy of Pediatric Tuina for children with URTIs compared with medication, no treatment or sham Pediatric Tuina were included for meta-analysis. Review Manager (V.5.3.5) and Stata14.0 were implemented for data analyses. Evidence certainty was evaluated by the GRADEprofiler software. Result: 12 randomized studies representing 1268 patients met the inclusion criteria. Pediatric Tuina increased the effective rate of URTIs (OR = 3.94, 95% CI: 2.61 to 5.95, P<0.00001), decreased the fever time of URTIs (MD =-0.72, 95% CI: -0.93 to -0.52, P<0.00001). The most commonly used manipulations of the included studies were pushing, kneading, pinching and nipping. The most frequently used acupoints were Tian He Shui, Tian Men, Kan Gong, Tai Yang, Fei Jing. According to the GRADE criteria, effective rate and the fever reliving time were low-quality evidence. Conclusion: Pediatric Tuina appears to show potential effectiveness in treating Upper Respiratory Tract Infections (URTIs) in children. However, the low certainty of evidence poses a challenge to the reliability of this conclusion. To establish a more solid foundation, multinational and well-conducted randomized clinical trials are essential. These trials would not only support the efficacy of Pediatric Tuina but also guide changes in clinical practice. In the context of relieving symptoms during acute URTI episodes, the common application of pushing and kneading on specific acupoints of Pediatric Tuina on the face and forearm has been observed.