<p>Children exposed to natural disasters and armed conflict face an elevated risk of mental health difficulties; however, the range and patterns of reported outcomes across studies remain insufficiently characterized. To synthesize evidence regarding mental health outcomes among school-attending children exposed to natural disasters and armed conflict. A systematic literature review was conducted using CINAHL, PubMed, Web of Science, Scopus, and EBSCO to identify studies published from 1 January 2013 to 1 July 2025. Eligible studies comprised observational research examining mental health in elementary and secondary students exposed to disasters or armed conflict. Two reviewers independently evaluated studies, extracted data, and assessed risk of bias. Twenty-seven studies met the inclusion criteria. Post-traumatic stress disorder (PTSD), depression, and anxiety were the most frequently reported mental health outcomes. Although most studies demonstrated minimal bias, substantial variation existed in study design, measurement instruments, and assessment timing. Factors, such as direct trauma exposure, family separation, and parental distress, were consistently associated with poorer mental health outcomes. Due to methodological heterogeneity, pooled outcome frequencies could not be calculated. This review demonstrates that post-traumatic stress disorder (PTSD), depression, and anxiety are the predominant mental health disorders assessed in schoolchildren exposed to disasters or armed conflict. The findings underscore the importance of contextual and familial influences in understanding children’s psychological responses. Further research employing standardized measures and longitudinal designs is necessary to enhance comparability across studies and inform the development of evidence-based interventions.</p>