BACKGROUND: Active play emphasizes the enjoyment of physical activity, it is affordable and unconstrained. In contrast, skill-oriented physical education, a mainstream physical activity intervention, is more formalized. However, the comparative effects of these interventions on fundamental movement skills in preschool children remain a subject of debate. PURPOSE: Determine the effectiveness of active play and compare it with skill-oriented physical education on fundamental movement skills. METHODS: We searched four databases (MEDLINE, ERIC, Web of Science, and SPORTDiscus) from January 2004 to March 2024. Included studies assessed FMS in children aged 2 to 6 years, with active play interventions lasting >= 4 weeks. The effects of active play and skill-oriented physical education on total fundamental movement skills, locomotor skills, object control, and balance were calculated within random effects models (weighted SMD) in meta-analysis. RESULTS: This systematic review included 23 studies involving 2201 preschool children, with 15 eligible for meta-analysis. The meta-analysis showed no significant differences in the effects of active play compared to skill-oriented physical education on total FMS, locomotor skills, object control, balance (p > 0.05). Subgroup analyses indicated that skill-oriented physical education marginally outperformed unstructured active play in total fundamental movement skills and locomotor skills (SMD -1.0172, 95% CI -1.6748 to approximately -0.3595, p = 0.0073; SMD -1.6956, 95% CI -3.3511 to approximately -0.0401, p = 0.0471). CONCLUSIONS: Both structured active play and skill-oriented physical education are comparable effective in improving fundamental movement skills. However, unstructured active play is less effective. In resource-limited educational settings, structured active play may serve as a viable complement to partial skill-oriented physical education programming.

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