Background Many healthcare systems are organised such that General Practitioners (GPs) often have a key role in identifying autism spectrum disorders (autism) in children. Yet a systematic understanding of GP knowledge and experiences identifying autism is currently lacking. In this review, we explored what GPs know about autism and the factors the influence their ability to identify and manage care for their patients with autism in practice.Methods We conducted a systematic narrative review using eight electronic databases. These included EMBASE and MEDLINE via Ovid, Web of Knowledge, PsycINFO via Ebscohost, PubMed, Scopus, ProQuest Dissertations and Thesis, and Applied Social Sciences Index and Abstracts (ASSIA) via ProQuest. Our search yielded 2,743 citations. Primary research studies were included, and we did not impose any geographical, language, or date restrictions.Results We identified 17 studies that met our inclusion criteria. These were published between 2003-2019. We thematically synthesised the material and identified the following themes: the prototypical image of a child with autism; experience and sources of information; barriers to identification; strategies to aid in identification; and characteristics that facilitate expertise. Conclusion Taken together, the findings from this review present a mixed picture of GP knowledge and experiences identifying autism and managing care for children with the condition. At one end of the continuum, there were GPs who had not heard of autism or endorsed outmoded aetiological theories. Others, however, demonstrated a sound knowledge of the conditions but had limited confidence in their ability to identify the condition. Many GPs and researchers alike called for more training and this might be effective. However, framing the problem as one of a lack of training risks silencing the array organisational factors that impact on a GPs ability to provide care for these patients.