How to make a PRISMA flow diagram
Updated 2026-09-24
Making a PRISMA flow diagram is mostly bookkeeping: keep accurate counts at every stage of your review, then place them in the right boxes. Follow these five steps.
Step 1: Choose the right template
Pick the PRISMA 2020 flow diagram that matches your review. Is it a new review or an update of an earlier one? Did you search databases and registers only, or also websites, organisations and citation searching? The four official templates cover each case.
Step 2: Count as you go
Record numbers while you work, not afterwards. Note how many records each database or register returned, how many duplicates or ineligible records you removed before screening, how many records you screened and excluded, and how many reports you sought, could not retrieve, assessed and excluded (with a reason for each exclusion).
Step 3: Fill in the boxes
Enter each number in its box. In the generator, the diagram updates live as you type. Name your actual databases (for example PubMed, Embase, CENTRAL) rather than using one generic count, and list exclusion reasons with their counts.
Step 4: Check the arithmetic
Every box should equal the one before it minus what was removed. If you identified 1,100 records and removed 260 duplicates, you should screen 840. Mismatches are the most common reason reviewers query a flow diagram. See the worked example for a full check.
Step 5: Export and insert
Export the diagram as PNG for quick use, SVG for a sharp, editable vector, or PDF for print. Insert it into your manuscript as Figure 1. For Word, see the guide to a PRISMA flowchart template for Word.
Common mistakes to avoid
- Counting reports and records as if they were the same thing.
- Forgetting to report reports that could not be retrieved.
- Giving exclusion reasons that do not add up to the excluded total.
- Using the 2009 layout for a new review.
Quick answers
How long does it take to make a PRISMA flow diagram?
If your counts are ready, a few minutes with a generator. Keeping accurate counts during screening is what takes the time.
Source of the flow diagram wording: Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi:10.1136/bmj.n71. Licensed CC BY 4.0. This site is independent and not affiliated with the PRISMA or EQUATOR Network groups.