A systematic review of the literature (1965–2022) and meta-analysis were undertaken to compare the school readiness skills of children participating in public pre-kindergarten (pre-K) or Head Start. Seven quasi-experimental studies met the inclusion criteria for the meta-analysis and 38 effect sizes were analyzed. Results indicated no reliable meta-analytic effect in relation to children’s school readiness skills overall nor in relation to language, mathematics, or social-behavioral skills specifically. A small, positive meta-analytic effect favoring public pre-K compared to Head Start participation was found in relation to children’s emergent literacy skills (Hedges’ g = 0.17). Strategies are discussed to further equate the benefits of public pre-K and Head Start programming by facilitating greater cross-sector collaboration.