Background: Respiratory viruses are common. Specific etiology remains without identification at least at 50% of the cases. Human Metapneumoviruses were identified en 2001; it is an important etiologic agent in low respiratory airway diseases in children. There are 4 diagnostic tools for human metapneumoviruses: serologic diagnosis, culture (gold standard), RNA detection by RT-PCR and antigens. There is no treatment for this infection. Research Question: In pediatric patients with respiratory airway infections caused by human metapneumovirus, what is the diagnostic accuracy (sensitivity, specificity, positive and negative predictive value) of PCR, culture, immunofluorescence and serologic diagnosis? Objective: Identify diagnosis accuracy (sensitivity, specificity, positive and negative predictive value) of PCR, culture, immunofluorescence and serologic diagnosis for human metapneumovirus in pediatric patients with lower airway infection or data to build 2x2 table. Methods: Types of studies: Diagnostic accuracy papers. Search Strategy: Keywords: Human Metapneumovirus, PCR, culture; immunofluorescence, serologic studies, antibodies, diagnostic test, diagnostic, diagnostic accuracy. We did search in these data bases: Lilacs, Artemisa, Scielo, Pubmed, Embase. Methodology Quality: All papers included in this review were measured with Stard and Quadas scales. Results: We got 169 papers. 147 were dismissed because they were not diagnostic accuracy papers or because they had incomplete data. At the end we had culture against culture (one paper), immunofluorescence against culture (one paper), PCR against culture (four papers), immunofluorescence against PCR (fourteen papers) and PCR against PCR (2 papers). Conclusion: The diagnostic test with the best diagnostic accuracy was culture. PCR is a useful diagnostic test with a good diagnostic accuracy but more studies are needed in order to get best evidence.