Limited data exist for health care providers regarding seizure recurrence after a first unprovoked seizure in previously neurologically and developmentally normal children. A systematic review and meta-analysis was conducted to assess seizure recurrence after a first unprovoked seizure by performing an electronic search in PubMed, Embase, and Scopus. Six studies from 2817 met the inclusion criteria. The sample size consisted of 815 neurologically and developmentally normal children (1 month-17.5 years) on no antiepileptic drugs. This systematic review and meta-analysis estimated a recurrence rate within 3 years of 45% (95% CI: 37%, 60%). This estimate provides a touchstone for health care providers who are managing this particular population of children.