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<b><i>Introduction:</i></b> Kangaroo care (KC) is defined by the World Health Organization as a method of care consisting in putting premature infants or newborns in skin-to-skin contact with their parents. KC is an effective method of promoting health and well-being of infants and their families. Physiological stability during KC has been widely analyzed, however with controversial results. <b><i>Methods:</i></b> A systematic review was conducted. Electronic databases searched included MEDLINE, Embase, CINAHL, and Scopus. Two authors independently reviewed and extracted information using a data extraction form. The methodological quality of the observational studies was assessed using “STROBE” and the “Cochrane Collaboration tool” for randomized controlled trials. The physiological monitoring parameters included were heart rate (HR), arterial oxygen saturation (SpO₂), regional cerebral oxygen saturation (rScO₂), and fractional oxygen extraction (FtOE). <b><i>Results:</i></b> A total of 345 articles were identified. First, 302 articles were excluded by title and then 34 articles after full-text analysis. Finally, a total of 25 studies were included. Physiological parameters monitored (HR, SpO₂, rScO₂, and FtOE) showed no significant changes at different study periods: pre-KC, during KC, and post-KC. <b><i>Conclusions:</i></b> We conclude that stable preterm infants receiving or not respiratory support show no significant differences in HR, SpO₂, FtOE during KC compared to routine incubator care. rScO₂ remains stable during KC with slight upward trend. Further studies with a higher level of methodological quality are needed to confirm these findings.

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