Abstract Intervention studies involving the use of sensory integration therapy (SIT) were systematically identified and analyzed. Twenty-five studies were described in terms of: (a) participant characteristics, (b) assessments used to identify sensory deficits or behavioral functions, (c) dependent variables, (d) intervention procedures, (e) intervention outcomes, and (f) certainty of evidence. Overall, 3 of the reviewed studies suggested that SIT was effective, 8 studies found mixed results, and 14 studies reported no benefits related to SIT. Many of the reviewed studies, including the 3 studies reporting positive results, had serious methodological flaws. Therefore, the current evidence-base does not support the use of SIT in the education and treatment of children with autism spectrum disorders (ASD). Practitioners and agencies serving children with ASD that endeavor, or are mandated, to use research-based, or scientifically-based, interventions should not use SIT outside of carefully controlled research. Highlights ► Research involving sensory integration therapy to autism was reviewed. ► Out of 25 studies, three studies had positive results. ► Serious methodological flaws were found across studies. ► The evidence-base does not support the use of SIT in the treatment of autism.