<p>Research examining empathy in autism spectrum disorder (ASD) has primarily focused on its cognitive component, neglecting the affective one. Moreover, there is a lack of systematic knowledge about empathy in children and adolescents with ASD. This will be addressed by the current systematic review. In accordance with PRISMA guidelines, 15 studies were selected from an initial pool of 1,081 records. They mostly included adolescent boys and involved comparisons with typically developing peers. Most studies (<i>n</i> = 10) reported intact affective empathy but deficits in cognitive empathy; a subset of studies (<i>n</i> = 5) found impairments in both domains. These findings contribute to a more nuanced understanding of empathy development in ASD during childhood and adolescence. Findings contribute to the conceptualization and assessment of empathy, ultimately informing the design and implementation of evidence-based interventions.</p>