Objective To summarize the best evidence best evidence on immunosuppressive drug management for pediatric kidney transplant recipients, and to provide a solid, evidence-based foundation for clinical practices in this area. Methods We used the PIPOST framework to form an evidence-based question. Then, we performed systematic searches using the "6S" evidence model. The databases searched included UpToDate, BMJ Best Practice, Web of Science, EBSCO, Cochrane Library, PubMed, CNKI, SinoMed, VIP Database, and Wanfang Data, etc. The search time frame spanned from the inception of the databases until March 2025. Results A total of 14 publications were included, comprising 1 evidence summary, 6 clinical guidelines, 2 systematic reviews, and 5 expert consensus reports. From these, 32 pieces of evidence were summarized in five key areas:multidisciplinary collaboration, perioperative immunosuppressant management, medication adherence management, health education and follow-up care, and transition medication management for adolescents after kidney transplantation. Conclusion The best evidence on immunosuppressive drug management for pediatric kidney transplant recipients can help standardize medication management strategies, improve patient adherence, and enhance long-term outcomes.