Background / Aim: Traditionally, research has focused more on mothers’ attitudes and their experiences with their children having Down Syndrome (DS). This study aims to identify various attitudes and perceptions of fathers toward their children with Down syndrome. Two research questions were formulated to further explore the aim.  Method: Four databases were used for the search process and five peer-reviewed studies met the predefined inclusion and exclusion criteria. Data were extracted using the overall data of 519 fathers as participants from the selected studies.  Results: A chronology comprising 5 primary categories with underlying themes was established. These categories reflect on different stages of a child's life, including infancy, middle childhood, adolescence, and middle adulthood. As well as other concerns of fathers such as gender roles, personal worries, and financial troubles were also identified. Additionally, the challenges and rewards of raising a child with DS were identified.  Conclusions: Despite the difficulties, fathers considered several strategies for accepting and helping their children. Fathers generally had a good attitude toward their children. However, it was found that there needs to be more knowledge of DS in society. Lastly, practical implications, limitations, and future research directions are discussed.