Background <p>The impact of living with overweight or obesity on child and adolescent postural control is being increasingly researched, yet heterogenous methodology leaves the relationship unclear.</p> Objective <p>This review aimed to investigate associations between adiposity and instrumentally assessed postural control in children/adolescents.</p> Methods <p>The review was registered a priori with PROSPERO and reported according to PRISMA guidelines. Searches across six electronic databases were conducted from inception to November 2024, and grey literature between December 2024 to January 2025. Eligibility required analyses of an adiposity measure with instrumented postural control in otherwise healthy children and adolescents of varying weight status. The McMaster Critical appraisal tool was used, and FORM framework guided the synthesis.</p> Results <p>A total of 5624 database articles and seven grey literature yielded 53 eligible articles, examining a total of 8509 participants. Higher adiposity was reported to be associated with impaired postural control in 31 studies, as having no/unclear associations in 13 studies, and improved postural control in 9 studies. Participants with increased weight status consistently showed impaired postural control in more challenging assessments. The FORM overall grade of recommendation was ‘C-satisfactory’.</p> Conclusion <p>Most outcomes reported increasing adiposity to be associated with poorer postural control. Clinicians are encouraged to screen children and adolescents with excess adiposity for postural control deficits using challenging test conditions.</p>