Gastroschisis is a prevalent pediatric congenital anomaly that has been rising in incidence over recent decades. Mortality rates differ significantly between high-income countries (HIC) and low- and middle-income countries (LMICs), with HICs experiencing higher survival. Despite higher survival rates in HICs, substantial morbidity persists due to prolonged hospital stays, and the need for parenteral nutrition until sufficient enteral nutrition is reached. This review aims to systematically review the effectiveness of standardized perioperative management gastroschisis care pathways in improving clinical outcomes such as mortality, length of stay, mechanical ventilation days, TPN days, days to full enteral nutrition, and infectious complications. A comprehensive literature search of the National Institute of Health MEDLINE database using PubMed was conducted, including citations from November 1986 to February 2023. Included studies evaluated gastroschisis management pathways. Excluded articles were non-English studies, case reports, systematic reviews, and studies not specifically addressing gastroschisis management pathways. GRADE methodology was used to assess data quality. The search yielded 127 articles, with 21 meeting inclusion criteria: 13 retrospective cohort studies, five prospective comparative studies with historical cohorts, and three case series. Mortality rates were significantly improved in LMICs after protocol implementation, while data from HICs were inconclusive. Length of stay data were mixed, with only one study showing a statistically significant decrease. Mechanical ventilation days and TPN days generally decreased with protocol use, particularly with comprehensive care pathways. Enteral nutrition advancement protocols varied widely, with limited studies showing significant reductions in days to full feeds. Infectious complications showed a potential reduction, especially with early enteral feeding protocols. Implementing standardized care pathways for gastroschisis management may improve outcomes, particularly in LMICs. However, the quality of the evidence is generally low, and further high-powered, randomized studies are needed to confirm these findings and refine care pathway components. Despite current limitations, standardized protocols are recommended due to their potential to enhance patient outcomes and resource utilization, with low risk for harm.