Objective To summarize the best evidence for posture management in children and adolescents with neurodevelopmental disorders, and to provide an evidence-based reference for clinical posture management, musculoskeletal deformity prevention and functional outcome improvement. Methods The evidence-based question was formulated using the PIPOST framework. A systematic search was performed following the 6S evidence model in UpToDate, BMJ Best Practice, Web of Science, Cochrane Library, PubMed, CNKI, CBM, VIP and Wanfang Data, from January 2021 to May 2026. ResultsA total of 35 articles were included, consisting of 5 guidelines, 20 systematic reviews/Meta-analyses, 8 randomized controlled trials and 2 expert consensuses. Twelve pieces of best evidence were extracted across 6 domains: 24-hour posture management, disease-specific interventions, assessment tools, stratified functional intervention, nighttime postural support and emerging technologies. ConclusionThe summarized best evidence for posture management in children and adolescents with neurodevelopmental disorders helps standardize clinical postural interventions, reduce the risk of musculoskeletal deformities, and support stratified, individualized rehabilitation management.