Children with autism spectrum disorders (ASD) experience difficulty with play, and a number of different interventions have been developed and evaluated to address this deficit. This systematic review of randomized controlled trials identified 19 studies reporting on play-based interventions for children with ASD aged 2-12 years. The components of each study, including elements of the interventions and methodological quality, were examined. A meta-analysis was completed for 11 studies, and a small but significant treatment effect was identified (Hedges' g = 0.439). The current review supports future development of interventions with a focus on the child with ASD across social environments. Outcome measures and comprehensive reporting of intervention components are important considerations in future intervention development and testing. Significance for clinicians and future research is discussed.