Cough in children is among the most common symptoms and may have a deep impact on children’s and parents’ sleep and quality of life, thus often requiring an empiric treatment with antitussive agents. Levodropropizine is a very well tolerated peripheral drug, while central cough suppressants (opioids and non opioids) may be associated with side effects that limit their use especially in children. After comprehensive literature search, a meta-analysis of 4 clinical studies of levodropropizine vs. control, including a total of 780 patients, was performed with the aim to evaluate the overall comparative efficacy of levodropropizine in the pediatric population. Meta-analysis of all standardized efficacy parameters (cough frequency, severity, and night awakenings) showed a highly statistically significant difference in the overall antitussive efficacy in favor of levodropropizine vs. control treatments (p=0.0044). The heterogeneity test for the efficacy outcome was not statistically significant (p=0.0856). Our meta-analysis indicates that levodropropizine is an effective antitussive drug in children, with statistically significant better overall efficacy outcomes vs. central antitussives (codeine, cloperastine, dextromethorphan), in terms of reducing cough intensity, frequency and nocturnal awakenings. These results further reinforce the favorable benefit/risk profile of levodropropizine in the management of cough in the pediatric setting.