Objective: To describe and analyze the current research status of compliance in orthokeratology among children and adolescents in and beyond China, so as to guide future research in this field. Methods: By combining subject words with free words, the paper systematically searched the research related to the compliance of children and adolescents wearing orthokeratology lenses in PubMed, Web of Science, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP and China Biomedical Literature Database. The retrieval time limit was until September 1, 2023.Two researchers independently screened and extracted data. Results: A total of 35 articles were included, and four themes were identified:the current level of compliance, evaluation indicators, influencing factors, and intervention programs. The evaluation indicators of orthokeratology lenswearing compliance were diverse, and the influencing factors involved general demographic characteristics, personal internal factors, external factors, and specific clinical situations related to orthokeratology. Conclusions Multiple factors are associated with compliance in orthokeratology. Eyecare practitioners should choose suitable evaluation tools based on specific conditions and implement diverse and practical intervention strategies guided by theory to enhance the safety and effectiveness of orthokeratology lenswearing among children and adolescents.