This paper presents a synthesis of current knowledge about occupational therapy in preschools (for 3-6 year olds) in order to provide a better understanding of this field of practice and to guide the implementation or programming of this service. In the literature, occupational therapy in preschools has been documented mainly in the USA. Results revealed that this service helped all children, with and without difficulties, to improve their skills, especially fine motor and graphomotor skills, and their participation in educational and daily living activities. Occupational therapy also had positive effects on teachers, parents and services. A service delivery model based on Response-to-Intervention or collaborative model should guide the implementation or programming of occupational therapy in preschools, with the focus on prevention/health promotion, screening and early intervention as well as school inclusion and success. Future studies are needed to determine the best intervention approaches and methods to improve children's motor skills and self-regulation in inclusive preschool settings. (author abstract)