Abstract
Biliary atresia (BA) is a leading cause of neonatal cholestasis and a major reason for pediatric liver transplantation (LT). Despite its clinical importance, research from the Indian subcontinent has historically been sparse and fragmented. Using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search, we identified 702 records and analyzed 64 eligible studies, most of which examined clinical features, surgical outcomes particularly after Kasai portoenterostomy, and short-term prognosis. Most existing research remains clinical, radiological, or laboratory based, with considerable variability across findings. Substantial gaps were noted, particularly in understanding disease mechanisms, etiopathogenesis, and diagnostic advancements. This highlights the need for more focused, conceptually driven, and collaborative efforts. To advance understanding and care of BA in the Indian context, future research must incorporate multidisciplinary approaches, including molecular, genetic, and public health perspectives. By building on the growing interest and solid clinical foundation, India is well positioned to develop a cohesive, forward-looking research framework that addresses current gaps and fosters innovation in the diagnosis, management, and long-term outcomes of BA.