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Background Across Organisation for Economic Co-operation and Development (OECD) countries, there is growing concern about the public health burden of children’s out-of-home care (OHC) placements and their health and social consequences, particularly in the context of frequently co-occurring early-life adversities. A substantial literature shows an association between disadvantaged socioeconomic conditions (SECs) and OHC – and, increasingly, the contribution of rising child poverty to rising OHC placement rates. However, the magnitude of the relationship remains unclear, the evidence base diffuse. This review aimed to synthesise evidence of the relationship between childhood SECs and OHC in developed countries.Methods We examined associations between SECs and OHC among children aged 0–17 in OECD countries, according to pre-registered method (PROSPERO CRD42021266991). We searched MEDLINE, Scopus, Web of Science Core Collection, CINAHL, PsycINFO, HMIC from 1980 to 16/9/2024, and Social Care Online from 1980- 4/8/2021. We also conducted a targeted search of Google Scholar and NICE Evidence Search and scanned the webpages of relevant organisations.Eligible studies reported information on the relationship between SECs and OHC in representative populations. Two reviewers independently screened titles/abstracts and full-texts in Rayyan, with conflicts resolved by a third. We undertook data extraction in Excel and quality appraisal using an adapted Liverpool University Quality Assessment Tool, with regular calibration meetings. Quality of adjustment was assessed based on an a priori causal diagram, which makes explicit our assumptions about data generation processes. We used meta-analysis, harvest plots, and/or tables and narrative synthesis depending on comparability of quantitative estimates.Results A total of 8,710 studies were identified; 823 progressed to full-text screening. Of these, 114 were eligible. To date, we have extracted data for 59 studies: descriptive results only from 21 studies; and effect estimates from the remaining 38. Most studies (36/38) reported an association between at least one measure of disadvantaged SECs and OHC. Where reported, 78% (80/123) of effect estimates suggested higher risk of OHC in more disadvantaged groups. Potential sources of heterogeneity include child age, ethnicity, SEC definition and country context. Analyses are ongoing.Conclusion The bulk of the evidence synthesised to date indicates that children from disadvantaged backgrounds face an increased risk of OHC placement. The heterogeneity of study designs and final quality assessment affect confidence in specific estimates. Overwhelmingly, appropriately adjusted results show a clear association. Further research is needed to understand modifiable mediating pathways from adverse SECs to OHC.