Researchers say their gold-standard review should put an end to the debate over use of the common painkiller during pregnancy.
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Pregnant women "should feel reassured" by the findings, they say, which contradict controversial claims from US President Donald Trump last year that paracetamol "is no good" and pregnant women should "fight like hell" not to take it.
His views were criticised at the time by medical organisations worldwide. Experts say this latest review, in a Lancet journal, is rigorous and should end the debate over its safety.
But US health officials maintain that "many experts" have expressed concern over its use during pregnancy.
The US President shocked many doctors worldwide when he and his administration claimed paracetamol or a branded version called Tylenol - which is seen as the go-to painkiller for pregnant women - could be linked to autism in children, if taken during pregnancy.
Those claims led to confusion among women and concern among health experts, and prompted this new research.
Published in The Lancet Obstetrics, Gynaecology & Women's Health, it looked at 43 of the most robust studies into paracetamol use during pregnancy, involving hundreds of thousands of women, particularly those comparing pregnancies where the mother had taken the drug to pregnancies where she hadn't.
The researchers say using these high-quality studies of siblings means they can dismiss other factors such as different genes and family environments, which makes their review "gold-standard".
The research also looked at studies with a low risk of bias and those that followed children for more than five years to check for any link.
"When we did this analysis, we found no links, there was no association, there's no evidence that paracetamol increases the risk of autism," lead study author and consultant obstetrician Professor Asma Khalil, told the BBC.
"The message is clear – paracetamol remains a safe option during pregnancy whe