The global increase in recreational escape rooms has inspired teachers around the world to implement escape rooms in educational settings. As escape rooms are increasingly popular in education, there is a need to evaluate their use, and a need for guidelines to develop and implement escape rooms in the classroom. This systematic review synthesizes current practices and experiences, focussing on important educational and game design aspects. Subsequently, relations between the game design aspects and the educational aspects are studied. Finally, student outcomes are related to the intended goals. Educators in different disciplines appear to have different motives for using the game’s time constraints and teamwork. These educators make different choices for related game aspects such as the structuring of the puzzles. Unlike recreational escape rooms, in educational escape rooms players need to reach the game goal by achieving the educational goals. More alignment in game mechanics and pedagogical approaches is recommended. There is a discrepancy in perceived and actual learning of content knowledge in recreational escape rooms. Recommendations in the article for developing and implementing escape rooms in education will help educators in creating these new learning environments, and eventually help students to foster knowledge and skills more effectively. Usually, educational escape rooms are based on recreational escape roomsThere is a discrepancy in perceived and actual learning in educational escape roomsEducators use the game's time constraints and teamwork for different reasonsIn educational escape rooms more alignment in game and educational aspects is neededDebriefings with reflection on learning might improve educational escape rooms