Abstract Exercise induced bronchoconstriction (EIB) may complicate childhood asthma. Leukotriene receptor antagonists (LTRAs), such as montelukast, may be beneficial in protecting against EIB. Our aim was to systematically review the role of LTRAs in the treatment of asthmas complicated by exercise induced bronchoconstriction and to assess various clinical factors which may influence the therapeutic outcome. Electronic searches were performed in the following databases: PubMed, CENTRAL, and the US National Institutes of Health Clinical Trial database. Following selection according to clearly defined inclusion and exclusion criteria and in accordance with the PRISMA statement; 5 double-blind, randomized, placebo-controlled trials of montelukast as monotherapy or add-on therapy in childhood asthma and 2 review articles were analysed in this systematic review. Treatment with LTRAs provides protection from EIB, when used as both monotherapy and add-on therapy. However, disease variables and aetiological factors may impact on the extent of clinical improvement. Genetic variability may influence leukotriene production and subsequent response to LTRAs. This issue could be addressed in further studies.