BACKGROUND Adolescent athletes are experiencing an increased number of concussions. There is currently a debate within the medical community regarding the most effective and safe treatment approach for this population, post-concussion. Interventions currently range from cognitive and physical rest to various types of physical activity, including aerobic exercise. While there are systematic reviews that focus on rest as the main intervention, there are no other systematic reviews that focus on the effects of aerobic exercise on concussion recovery in adolescent athletes. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the effectiveness of aerobic exercise on concussion recovery for adolescent athletes compared to an alternate intervention. METHODS Systematic Review and Meta-Analysis. METHODS A computer-based search (population: adolescent athletes with concussions, intervention: aerobic exercise, comparator: non-aerobic interventions, outcome: symptom severity and recovery time) was performed. Databases including PubMed, CINAHL, SPORTdiscus, ProQuest, and Scopus were searched up to December 2019 for randomized controlled trials published since 1965. A hand search of relevant articles and exploration of grey literature was also completed. Data were extracted for the following information: interventions prescribed, outcome measures, and overall results of the study. A meta-analysis was performed for aerobic interventions using standardized mean difference as the summary measure of effect. RESULTS Five studies, which all held a moderate to low risk of bias according to the PEDro scale, met the inclusion criteria for this systematic review and meta-analysis. Overall results favored aerobic exercise for both acute and prolonged recovery symptoms as demonstrated by a decrease in symptom severity and improved recovery time. The meta-analysis revealed a moderate effect size in favor of the intervention group (SMD: 0.51, CI: 0.02, 0.81, p=0.00) when looking at the three outcome measures combined: Post-Concussion Symptom Scale, Post-Concussion Symptom Inventory, and recovery time. CONCLUSIONS The results of this systematic review and meta-analysis indicate that there is currently moderately significant evidence in support of implementing an aerobic exercise program for adolescent athletes with both acute and prolonged recovery concussion symptoms. Additional higher quality studies are needed to continue to study the effectiveness of aerobic exercise in post-concussion treatment of adolescents. METHODS 1a.