نبذة مختصرة : Abstract Background Robust synthesis of evidence to support treatment recommendations for preschoolers with attention‐deficit/hyperactivity disorder (ADHD) is lacking. The aim of this systematic review and meta‐analysis was to review currently available evidence to evaluate the efficacy and acceptability of stimulants for preschool children with ADHD. Methods We searched electronic databases (CENTRAL, Embase, PubMed) from the database inception to March, 2022; and clinical trial registries through WHO ICTRP from the database inception to July, 2022, and selected double‐blinded randomized controlled trials (RCTs) that compared stimulants against placebo for the treatment of preschoolers (age ≤ 7 years) with ADHD. Change in ADHD symptom severity was the primary outcome (efficacy) and all‐cause dropout rates (acceptability) was the secondary outcome. Data were pooled with random‐effects models weighted by the inverse of the variance. Risk of bias of individual studies were assessed with the Cochrane Risk of Bias tool version 2. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of evidence. This study is registered with PROSPERO (CRD42022348597). Results Five RCTs (three methylphenidate immediate‐release, one methylphenidate extended‐release, and one lisdexamfetamine) were included. The analysis of efficacy was based on 489 participants. Meta‐analysis of change in ADHD symptom severity demonstrated a significant effect in favor of stimulants over placebo (standardized mean difference = −0.59; 95% CI −0.77, −0.41; p
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