Clinicians, researchers, and global health advocates often include pubertal development in outcomes. However, assessments of pubertal stage can be challenging due to the sensitive nature and feasibility of clinical examinations, especially in larger settings.To determine the accuracy of self-assessed Tanner Staging when compared to physically-assessed Tanner Stages by a clinician.MEDLINE, Pubmed, Embase, Web of Science, Scopus, the Cochrane Library, CINHAL.Studies were included if they reported 5x5 tables of self-assessment compared to clinician-assessment for the five-stage Tanner scale.We extracted data to generate complete 5x5 tables for each study, including any sub-group eligible for the analysis, such as overweight/obese youth.After screening, 22 studies representing 21,801 participants met our inclusion criteria for the meta-analysis. Overall agreement was moderate or substantial between the two assessments, with breast stage 1, female pubic hair 1, male pubic hair 1 and male pubic hair 5 having the highest agreement. When stages were collapsed into pre- (Tanner stage1), in- (stages 2,3) and completing- (stages 4,5) puberty, levels of agreement improved, especially for pre- and completing- pubertal development. Most included studies were comprised of Caucasian youth. More studies from broader geographic and socioeconomic settings and including a broader range of racial/ethnic groups are needed.Self-assessment of puberty is most accurate when identifying Tanner stage 1 and Tanner stage 5 and when development is categorized into pre-puberty, in- and completing-puberty phases. Use of self-assessment data should be structured accordingly.

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