OBJECTIVES: This study aims to compare the effectiveness of rice-based ORS as compared with glucose-based ORS in the treatment of acute watery diarrhea among children. Specifically, it aims to review and analyze the effectiveness of rice-based ORS as compared to glucose-based ORS as to stool output, duration of diarrhea and effect of osmolarity on treatment of diarrhea and to determine associated adverse events associated with rice-based ORS and glucose-based ORS. METHOD: This study used systemic review and meta-analysis of randomized trials. Primary outcomes were computed with 95% confidence intervals to determine the effectiveness of ricebased ORS. Adverse event was expressed as risk ratios with 95% confidence intervals. RESULTS: Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60). CONCLUSION Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60).