A systematic review and narrative synthesis found a lack of research on the lived experiences of Māori and Pacific children with respiratory conditions, and their whānau. A total of 29 studies published between 2010 and 2022, enrolling Māori or Pacific children aged 0–14 years, were included in the analysis. Most were retrospective cohort studies focused on asthma, group A streptococcus and lower respiratory tract infections. Only two studies reported using a Kaupapa Māori framework. Further research incorporating culturally responsive approaches is urgently needed to improve understanding of Māori and Pacific child respiratory health and to advance health equity, concluded the study authors.