Upper quadrant musculoskeletal pain (UQMP) is a common health problem in children and adolescents. The upper quadrant refers to the occiput, cervical and upper thoracic spine including the clavicles and scapulae. The current literature, which indicates that sitting, in terms of sedentary activities and sitting spinal posture, is a possible risk factor of UQMP, is controversial. This systematic review is aimed at ascertaining whether there is evidence for sitting as a risk factor for UQMP, and determining the different elements of sitting that are related to UQMP experienced by children and adolescents.