? This living systematic review represents an important effort to establish an evidence base for pediatric cannabinoid use, yet clinicians should recognize that the field remains characterized by limited high-quality randomized controlled trials, heterogeneous outcome measures, and sparse long-term safety data in developing brains. While cannabinoids show promise for specific indications like treatment-resistant epilepsy and chemotherapy-related nausea, extrapolation to other conditions remains problematic given the current evidence landscape. The absence of robust pharmacokinetic data in children, variable cannabinoid composition across products, and the challenge of distinguishing genuine therapeutic effects from placebo responses further complicate clinical decision-making. Until this living review and similar efforts accumulate more rigorous evidence, clinicians prescribing cannabinoids to children should do so only for conditions with established benefit, maintain detailed documentation of rationale and outcomes, and counsel families transparently about uncertainties regarding long-term neurodevelopmental effects.