Background: Pediatric liver cirrhosis, characterized by irreversible liver damage, presents a significant yet often overlooked challenge within pediatric healthcare. This condition, resulting from genetic, metabolic disorders, or acquired diseases, severely impairs liver function essential for children's growth and development. Although less common than in adults, its impact on young patients and their families is profound, necessitating considerable healthcare resources for management, including potential liver transplantation. Objective: This systematic review aims to synthesize existing research on the prognosis and long-term outcomes of pediatric liver cirrhosis, providing a comprehensive overview to enhance understanding and inform future care strategies. Methods: A rigorous literature search was conducted across databases including PubMed, Scopus, Web of Science, and EMBASE, from January 2000 to December 2023. Studies were selected based on stringent criteria focusing on pediatric populations diagnosed with liver cirrhosis and reporting on prognosis or long-term outcomes. Quality and bias assessments were systematically performed to ensure the reliability of findings.