Introduction: The passive leg raising (PLR) test is a non-invasive diagnostic tool for assessing fluid responsiveness, a pivotal aspect in hypotension management. Despite its growing application, a unified comparative assessment of prognostic accuracy for various PLR test parameters is currently lacking. Objective: Our study aimed to evaluate the efficacy of different PLR test indicators in predicting fluid responsiveness. Methods: We conducted a network meta-analysis, analyzing prospectivestudies that explored diagnostic accuracy of PLR test for fluid responsiveness. Electronic databases were searched until March 2024; this search was supplemented by snowballing methods. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of evidence. Results: Sixteen prospective cohort studies involving 784 patients were included. The network meta-analysis revealed that cardiac output parameters measured during the PLR test have the highest prognostic significance for assessing fluid responsiveness compared to other parameters (SUCRA score = 88.3). Utilizing arterial blood flow indicators results in a moderate prognostic value for the PLR test (SUCRA score = 72.0). The use of such conventional parameters as arterial blood pressure and inferior vena cava diameter reduces prognostic accuracy to unsatisfactory levels (SUCRA score < 50). The superiority of PLR test prognostic capability when using cardiac output parameters over arterial blood pressure indicators is supported by high-quality evidence. Conclusion: Our network meta-analysis demonstrated that using PLR test with cardiac output parameters ensures maximum sensitivity and specificity. Consequently, the use of more straightforward and easily obtainableparameters (arterial blood pressure, inferior vena cava diameter) is not recommended for assessing fluid responsiveness. Received 9 October 2025. Revised 14 October 2025. Accepted 18 February 2026. FundingThe study did not have sponsorship. Conflict of interestThe authors declare no conflict of interest. Contribution of the authorsConception and study design: V.V. Likhvantsev, L.B. Berikashvili Data collection and analysis: I.V. Kuznetsov, P.V. Ryzhkov, M.Ya. Yadgarov, L.B. Berikashvili Statistical analysis: M.Ya. YadgarovDrafting the article: I.V. Kuznetsov, L.B. Berikashvili, M.Ya. Yadgarov, A.G. Yavorovskiy, A.A. Yakovlev Critical revision of the article: V.V. Likhvantsev Final approval of the version to be published: all authors