Leisure participation has been associated with happiness and well-being in children. Individuals born preterm are at greater risk for motor, cognitive and behavioral difficulties which may contribute to difficulties participating in leisure activities. This systematic review examined the current knowledge on participation in leisure activities in individuals born preterm throughout the lifespan as compared to term born controls. An electronic search of eight databases for articles published up to October 2011 was conducted. The quality of each study was assessed using a standardized checklist. Thirteen studies met the selection criteria. In school-age children, no significant differences were found in activity levels between children born prematurely and term born controls. In adolescents, leisure scores in social activities, hobbies and sports were statistically significantly lower compared to controls. In young adults, differences in frequency and intensity of physical activity were reported compared to term controls. Promoting participation in leisure activities should be encouraged at a young age and continued to adulthood by minimizing the gaps between capabilities and the demands of the tasks and the environment. (Contains 1 figure and 2 tables.)