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BACKGROUND Artificial intelligence (AI) based on deep learning (DL) algorithms has shown promise in enhancing the speed and accuracy of dental anomaly detection in paediatric dentistry. AIM This systematic review aimed to investigate the performance of AI systems in identifying dental anomalies in paediatric dentistry and compare it with human performance. DESIGN A systematic search of Scopus, PubMed and Google Scholar was conducted from 2012 to 2022. Inclusion criteria were based on problem/patient/population, intervention/indicator, comparison and outcome scheme and specific keywords related to AI, DL, paediatric dentistry, dental anomalies, supernumerary and mesiodens. Six of 3918 initial pool articles were included, assessing nine DL sub-systems that used panoramic radiographs or cone-beam computed tomography. Article quality was assessed using QUADAS-2. RESULTS Artificial intelligence systems based on DL algorithms showed promising potential in enhancing the speed and accuracy of dental anomaly detection, with an average of 85.38% accuracy and 86.61% sensitivity. Human performance, however, outperformed AI systems, achieving 95% accuracy and 99% sensitivity. Limitations included a limited number of articles and data heterogeneity. CONCLUSION The potential of AI systems employing DL algorithms is highlighted in detecting dental anomalies in paediatric dentistry. Further research is needed to address limitations, explore additional anomalies and establish the broader applicability of AI in paediatric dentistry.