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Despite a steady increase in Prekindergarten (PreK) access every year, a large proportion of children in the U.S. still do not attend any center-based programs before kindergarten. Intrigued by this phenomenon, recent scholars have paid attention to examining parental PreK decision-making. Acknowledging that PreK exists in the intersection of early childhood education and K-12 worlds, the purpose of this systematic review and meta-synthesis is to synthesize studies on childcare and PreK decision-making and make suggestions to improve families’ equitable access to PreK. I conducted searches through online databases and included 48 eligible studies that met criteria. I found that existing studies on parental PreK decision-making are limited in understanding families’ life contextual factors affecting their PreK decisions and equitable access.