We conduct the first systematic review of the impact of health insurance on children and their households in low- and middle-income countries where nine-tenths of the world's child population reside. We find only 13 studies for seven countries published between 2000 and 2014 which assess the insurance impacts for children, controlling for self-selection and heterogeneity. Nine out of 10 studies reviewed provide consistent evidence that health insurance provides financial protection. The results are more mixed for health utilisation and health outcomes. Policy-makers would benefit from additional research on whether and how health insurance benefits children.