Peer-mediated interventions (PMI) are implemented for skills teaching for children with autism spectrum disorder (ASD), particularly within the context of early learning environments. PMI have several potential advantages in comparison to adult-led intervention; however, there is a lack of research evaluating the use of PMI with younger populations. This review aims to synthesize the literature regarding the use of PMI in skills teaching for children with ASD in preschool settings. A systematic search of the literature spanning 1980-2018 was conducted, and 31 articles were identified for inclusion. Results are discussed in relation to participant and peer characteristics, PMI procedures, target skills, intervention outcomes, and research strength. The effectiveness of PMI is discussed along with directions for future research.