Evidence suggests that growing up with an autistic sibling can have positive and negative effects on typically developing young people. However, ‘tension’ is not commonly explored in the literature. In this context, tension is regarded as feelings of worry, anxiety and conflict – for example, typically developing young people might feel protective of their autistic sibling but at the same time feel jealous of the amount of time their parents spend with them. This article details a qualitative synthesis analysis of the literature that investigated the effects of having an autistic sibling on typically developing young people. Two main themes were identified: childhood experiences and acceptance; and difficulties and social issues. The article discusses how these themes affect typically developing siblings positively or negatively and may cause tension. The authors also make some recommendations for future research and practice.