A systematic review was performed of the diagnostic test accuracy of brain natriuretic peptide (BNP) or amino-terminal pro-B-type natriuretic peptide (NT-proBNP) for the diagnosis of hemodynamically significant patent ductus arteriosus. Ten studies were included for BNP. The summary estimate for sensitivity was 88% and for specificity, 92%. Eleven studies were included for NT-proBNP. The summary estimate for sensitivity was 90% and for specificity, 84%. Studies varied widely in their methodological quality, type of commercial assay, thresholds, age at testing, gestational age, and whether the assay was used to initiate medical or surgical therapy. Therefore the authors recommend local validation of the assays before routine use for diagnosis or treatment decisions.