Background: Obstructive sleep apnea (OSA) is a prevalent and potentially serious condition in children, with significant implications for health and development. Limited data exists on the prevalence and management of OSA in Saudi Arabian children. Objective: To study the prevalence and management of OSA in children residing in Saudi Arabia. Methods: An extensive search of PubMed, Web of Science, Scopus, and Science Direct was performed to locate relevant material. Rayyan QRCI was used to select the eligible articles. Results: Our data includes eight articles with 2619 children, 1254 (47.8%) of whom were males. The prevalence of OSA in Saudi children ranged from 6.6% in school children to 50% in children with SCD, with a total prevalence of 208 (9.9%). Adenotonsillectomy (AT) successfully and effectively managed OSA and lifestyle modifications improved the outcomes of AT. Anti-inflammatory therapy with a combination of nasal steroids and anti-leukotriene significantly lowers the adenectomy rate. Some orthodontic evaluation and orofacial morphology were significantly associated with a higher incidence of OSA. Conclusion: The prevalence of OSA in Saudi children is generally low but rising among children with SCD. AT and lifestyle modifications can reduce the severity and symptoms of sleep apnea in Saudi children with OSA. Anti-inflammatory and steroid therapy was reported to decrease the rate of implementing AT. Certain craniofacial traits were more common, but not consistently, in a subset of juvenile OSA patients. Effective care necessitates a comprehensive approach that includes early detection, surgical and non-surgical procedures, and addressing underlying risk factors like obesity and allergies. By addressing current hurdles and utilizing future research, Saudi Arabia's healthcare system may enhance the quality of life for children with OSA.