Purpose: To synthesise research literature describing elements of community recreation and leisure activities that create meaningful participation experiences for children and youth with disabilities. Method: Database searches of Medline, Embase, PsycINFO, ERIC, SportDiscus, CINAHL, Scopus and Web of Science were conducted. Studies describing the experience of participating in a community-based programme or activity from the perspectives of children and youth with a disability aged 0–21 or their parents, and published in English were included. Meta-ethnography was used to synthesise qualitative data, and resulting themes were conceptualised in the International Classification of Functioning, Disability and Health-Child and Youth version. Consultation with stakeholders occurred throughout the review process. Results: The search identified 9544 articles, of which 20 were included for review. Ten elements contributing to meaningful participation experiences were identified and organised as follows: person-based elements (n = 5; having fun, experiencing success, belonging, experiencing freedom, developing an identity); environment-focused elements (n = 4; authentic friendships, the opportunity to participate, role models, family support) and activity-related elements (n = 1; learning). Conclusions: Elements contributing to meaningful leisure participation are interrelated. This review reveals the substantial contribution that meaningful interactions and relationships have in creating and facilitating positive and engaging experiences. Outcomes of this review may assist professionals in the design of targeted interventions to facilitate leisure participation. Implications for RehabilitationElements identified in this review may operate as core components of interventions that aim to optimise participation outcomes in community-based leisure activities.Supportive relationships and the availability of services are specific aspects of the environment that needs to be considered by health professionals to facilitate meaningful participation.Understanding the perspectives of the child is critical for assessing needs, preferences and goals relating to leisure participation in the community.