CONTEXT Children with congenital heart disease (CHD) are at risk of cerebral abnormalities. Current evidence is limited by small sample sizes, single-center cohorts, and single time points. OBJECTIVE Conduct a systematic review and meta-analysis to determine the prevalence of structural cerebral abnormalities on magnetic resonance imaging (MRI) in children with CHD during prenatal, postnatal–preoperative, and postoperative periods. DATA SOURCES Five electronic databases from inception to August