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This meta-analysis examines the inconsistent findings across experimental studies that compared children’s learning outcomes with digital and paper books. We quantitatively reviewed 39 studies reported in 30 articles (n = 1,812 children) and compared children’s story comprehension and vocabulary learning in relation to medium (reading on paper versus on-screen), design enhancements in digital books, the presence of a dictionary, and adult support for children aged between 1 and 8 years. The comparison of digital versus paper books that only differed by digitization showed lower comprehension scores for digital books. Adults’ mediation during print books’ reading was more effective than the enhancements in digital books read by children independently. However, with story-congruent enhancements, digital books outperformed paper books. An embedded dictionary had no or negative effect on children’s story comprehension but positively affected children’s vocabulary learning. Findings are discussed in relation to the cognitive load theory and practical design implications.