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This systematic review aggregates and outlines the available data surrounding current applications and adverse events of pediatric CED to benchmark safety as protocols expand. A comprehensive search through CINAHL, Cochrane, OVID Medline, and Scopus databases was conducted using a modified PRISMA analysis. After deduplication and screening, final articles were selected for data extraction. Of 108 unique articles, 12 studies met the inclusion criteria, including 162 patients (51% males, 44% females, and 5% not reported). The average age was 8.64\u00a0years (range 5\u201314.1\u00a0years). The most common indication for CED was for unresectable high-grade glioma (92%), predominantly diffuse intrinsic pontine glioma (83%). CED also addressed genetic enzyme deficiency (8%). The trans-frontal approach was most common (58%), with single catheter systems employed in 50% of studies. A total of 285 adverse events were reported. The most common included headache (20%), limb weakness (18.2%), Grade 1 cranial nerve deficits (6.3%), and general pain (4.9%). Of 132 CTCAE-graded events, 125 were Grade 1 or Grade 2 (94.7%) and 7 were Grade 3 (5.3%). No Grade 4 or Grade 5 adverse events occurred. This first systematic review of CED of pediatric patients demonstrates that while mild side effects are common, severe adverse events are rare. Multi-institutional and longitudinal data are needed to further define CED\u2019s role in pediatric applications. These findings support CED as a viable platform for investigational therapies in treatment-resistant pediatric pathologies.<\/jats:p>","DOI":"10.1007\/s00381-025-07121-8","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:34:58Z","timestamp":1768530898000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Protocols and safety profile of convection enhanced delivery in pediatric patients: a systematic review"],"prefix":"10.1007","volume":"42","author":[{"given":"Nathan S.","family":"Fredricks","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Harkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances T.","family":"Morden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Dewan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"7121_CR1","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1007\/s13311-017-0520-4","volume":"14","author":"AM Mehta","year":"2017","unstructured":"Mehta AM, Sonabend AM, Bruce JN (2017) Convection-enhanced delivery. 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