BACKGROUND: Anxiety is a rising mental health issue among children and adolescents, impacting their well-being and daily functioning. Research indicates at least 6% of children experience anxiety. Animal-assisted therapy (AAT) offers a promising, drug-free intervention that could reduce anxiety and be applied across various settings, making this research important for expanding mental health treatment options. OBJECTIVE: This literature review aims to examine whether animal-assisted therapy is connected to lowered levels of anxiety among children and adolescents. METHODS: Articles were identified through a search of Medline Complete, Cochrane Library, and Google Scholar. Studies were considered if they were peer-reviewed original research articles available in English that had to include all three elements: animal-assisted therapy, anxiety, and the specified age population groups. A total of 9 studies were identified and included in this review. RESULTS: The studies included six randomized controlled trials, one quasi-experimental study, and, two cohort studies. The studies had ages ranging from 5 to 31 and sample sizes between 12 and 153. Eight out of nine studies found an inverse association between AAT and anxiety levels. One study did not find a significant association, but anxiety levels in the control group increased. CONCLUSIONS: The results of this review indicate that AAT improves anxiety among children and adolescents. The number of RCTs on this research question provide a high level of evidence. In healthcare and therapeutic settings there should be a wider implementation of Animal-Assisted Therapy (AAT), to provide a natural alternative to medication for anxiety management. Future research should focus on increasing generalizability by studying diverse populations, and exploring the effect of different types of animals.