Aim: This study assesses the efficacy and safety of IL-1-targeted biological agents(BAs) in pediatric juvenile idiopathic arthritis (JIA), a condition characterized by chronic inflammation from excessive proinflammatory cytokine production, especially IL-1. Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted through May 2024 for randomized controlled trials (RCTs) comparing IL-1-targeted BAs (anakinra, canakinumab, rilonacept, gevokizumab, and bermekimab) with placebo in JIA. Efficacy was assessed using ACR 30 response. Safety was evaluated using serious adverse events (SAEs).Pairwise and network meta-analyses (NMA) were performed, analyzing parallel and withdrawal RCTs separately. Results: Six RCTs (four parallel and two withdrawal) were identified, involving anakinra, canakinumab, and rilonacept. In parallel RCTs, IL-1-targeted BAs significantly improved ACR 30 response compared with placebo [OR = 7.03, 95% CI (1.54, 32.30), I² = 74%, P = 0.008]. In withdrawal RCTs, fewer patients in the IL-1 group reported disease flare [OR = 0.27, 95% CI (0.13, 0.55), I² = 0.00%, P = 0.909]. SAEs did not differ from placebo in either trial type. The NMA showed canakinumab was more effective than rilonacept [OR = 14.05, 95% CI (2.93, 67.45)], with similar SAE risks among BAs. The SUCRA of ACR 30 response shows that canakinumab ranked first. Conclusion: IL-1-targeted BAs were more effective than placebo in treating JIA without increasing SAEs, with canakinumab being particularly effective. However, differences in ACR 30 criteria and trial heterogeneity should be considered.