PRISMA flow diagram for a systematic review
Updated 2026-09-24
In a systematic review the PRISMA flow diagram is the standard way to report study selection. Here is what belongs in it and how to keep it defensible.
What reviewers expect
Journals and peer reviewers look for a diagram that shows every stage from the search to the final included studies. The PRISMA 2020 checklist item 16a asks you to describe the results of the search and selection process, ideally with a flow diagram, and item 16b asks you to cite studies that might appear to meet the criteria but were excluded, and explain why.
What to include
- Number of records from each database and register, named individually.
- Records removed before screening: duplicates, records marked ineligible by automation tools, and other reasons.
- Records screened and excluded at title and abstract.
- Reports sought, not retrieved and assessed for eligibility at full text.
- Reports excluded, each with a reason and a count.
- Studies and reports included in the review.
Tips for a defensible diagram
Keep a log while screening so the diagram is built from data, not memory. Use the same exclusion reasons as your protocol, and order them consistently. If you updated the search, report the date of the latest search in your methods and use the updated review template if you are extending an earlier review.
Build yours
Use the generator to fill in the template and export your figure, or follow the step-by-step guide. Working on a scoping review instead? See the scoping review guide.
Quick answers
Does a meta-analysis need a PRISMA flow diagram?
Yes. A meta-analysis is normally part of a systematic review, and the same PRISMA flow diagram reports its study selection.
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.