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Currently, there are no clear-cut clinical or laboratory parameters to diagnose asthma in young children. Spirometry or the lung function tests cannot be reliably measured in children less than 5 years. The purpose of this study is to evaluate the efficacy of serum eosinophilic cationic protein (sECP) in diagnosing asthma among children less than 5 years of age. A systematic review was performed in PubMed, EMBASE, and Web of Science databases to identify studies investigating the role of sECP in diagnosing childhood asthma. The quality