diff --git a/classes.py b/classes.py
index bc2df19..fc575ef 100644
--- a/classes.py
+++ b/classes.py
@@ -53,6 +53,7 @@ def __init__(
         self.assignee = assignee
         self.assignees = assignees or []
         self.time_to_first_response = time_to_first_response
+        self.time_to_first_review = None
         self.time_to_close = time_to_close
         self.time_to_answer = time_to_answer
         self.time_in_draft = time_in_draft
diff --git a/config.py b/config.py
index d756290..d2fe279 100644
--- a/config.py
+++ b/config.py
@@ -39,6 +39,7 @@ class EnvVars:
         hide_time_to_close (bool): If true, the time to close metric is hidden in the output
         hide_time_to_first_response (bool): If true, the time to first response metric is hidden
             in the output
+        hide_time_to_first_review (bool): If true, the time to first review metric is hidden in the output
         hide_created_at (bool): If true, the created at timestamp is hidden in the output
         hide_status (bool): If true, the status column is hidden in the output
         ignore_users (List[str]): List of usernames to ignore when calculating metrics
@@ -79,6 +80,7 @@ def __init__(
         hide_time_to_answer: bool,
         hide_time_to_close: bool,
         hide_time_to_first_response: bool,
+        hide_time_to_first_review: bool,
         hide_created_at: bool,
         hide_status: bool,
         ignore_user: List[str],
@@ -114,6 +116,7 @@ def __init__(
         self.hide_time_to_answer = hide_time_to_answer
         self.hide_time_to_close = hide_time_to_close
         self.hide_time_to_first_response = hide_time_to_first_response
+        self.hide_time_to_first_review = hide_time_to_first_review
         self.hide_created_at = hide_created_at
         self.hide_status = hide_status
         self.enable_mentor_count = enable_mentor_count
@@ -148,6 +151,7 @@ def __repr__(self):
             f"{self.hide_time_to_answer}, "
             f"{self.hide_time_to_close}, "
             f"{self.hide_time_to_first_response}, "
+            f"{self.hide_time_to_first_review}, "
             f"{self.hide_created_at}, "
             f"{self.hide_status}, "
             f"{self.ignore_users}, "
@@ -269,6 +273,7 @@ def get_env_vars(test: bool = False) -> EnvVars:
     hide_time_to_answer = get_bool_env_var("HIDE_TIME_TO_ANSWER", False)
     hide_time_to_close = get_bool_env_var("HIDE_TIME_TO_CLOSE", False)
     hide_time_to_first_response = get_bool_env_var("HIDE_TIME_TO_FIRST_RESPONSE", False)
+    hide_time_to_first_review = get_bool_env_var("HIDE_TIME_TO_FIRST_REVIEW", False)
     hide_created_at = get_bool_env_var("HIDE_CREATED_AT", True)
     hide_status = get_bool_env_var("HIDE_STATUS", True)
     hide_pr_statistics = get_bool_env_var("HIDE_PR_STATISTICS", True)
@@ -293,6 +298,7 @@ def get_env_vars(test: bool = False) -> EnvVars:
         hide_time_to_answer,
         hide_time_to_close,
         hide_time_to_first_response,
+        hide_time_to_first_review,
         hide_created_at,
         hide_status,
         ignore_users_list,
diff --git a/issue_metrics.py b/issue_metrics.py
index 59ca338..5a45815 100755
--- a/issue_metrics.py
+++ b/issue_metrics.py
@@ -39,6 +39,10 @@
     get_stats_time_to_first_response,
     measure_time_to_first_response,
 )
+from time_to_first_review import (
+    get_stats_time_to_first_review,
+    measure_time_to_first_review,
+)
 from time_to_merge import measure_time_to_merge
 from time_to_ready_for_review import get_time_to_ready_for_review
 
@@ -159,7 +163,13 @@ def get_per_issue_metrics(
                 issue_with_metrics.pr_comment_count = count_pr_comments(
                     issue, pull_request, ignore_users
                 )
-
+            if not env_vars.hide_time_to_first_review and pull_request:
+                issue_with_metrics.time_to_first_review = measure_time_to_first_review(
+                    issue,
+                    pull_request,
+                    ready_for_review_at,
+                    ignore_users,
+                )
             if env_vars.hide_time_to_first_response is False:
                 issue_with_metrics.time_to_first_response = (
                     measure_time_to_first_response(
@@ -305,6 +315,7 @@ def main():  # pragma: no cover
             write_to_markdown(
                 issues_with_metrics=None,
                 average_time_to_first_response=None,
+                average_time_to_first_review=None,
                 average_time_to_close=None,
                 average_time_to_answer=None,
                 average_time_in_draft=None,
@@ -333,6 +344,7 @@ def main():  # pragma: no cover
             write_to_markdown(
                 issues_with_metrics=None,
                 average_time_to_first_response=None,
+                average_time_to_first_review=None,
                 average_time_to_close=None,
                 average_time_to_answer=None,
                 average_time_in_draft=None,
@@ -365,6 +377,7 @@ def main():  # pragma: no cover
     )
 
     stats_time_to_first_response = get_stats_time_to_first_response(issues_with_metrics)
+    stats_time_to_first_review = get_stats_time_to_first_review(issues_with_metrics)
     stats_time_to_close = None
     if num_issues_closed > 0:
         stats_time_to_close = get_stats_time_to_close(issues_with_metrics)
@@ -385,6 +398,7 @@ def main():  # pragma: no cover
     write_to_json(
         issues_with_metrics=issues_with_metrics,
         stats_time_to_first_response=stats_time_to_first_response,
+        stats_time_to_first_review=stats_time_to_first_review,
         stats_time_to_close=stats_time_to_close,
         stats_time_to_answer=stats_time_to_answer,
         stats_time_in_draft=stats_time_in_draft,
@@ -400,6 +414,7 @@ def main():  # pragma: no cover
     write_to_markdown(
         issues_with_metrics=issues_with_metrics,
         average_time_to_first_response=stats_time_to_first_response,
+        average_time_to_first_review=stats_time_to_first_review,
         average_time_to_close=stats_time_to_close,
         average_time_to_answer=stats_time_to_answer,
         average_time_in_draft=stats_time_in_draft,
diff --git a/json_writer.py b/json_writer.py
index 5dcd288..67834f9 100644
--- a/json_writer.py
+++ b/json_writer.py
@@ -4,6 +4,7 @@
     write_to_json(
         issues_with_metrics: Union[List[IssueWithMetrics], None],
         stats_time_to_first_response: Union[dict[str, timedelta], None],
+        stats_time_to_first_review: Union[dict[str, timedelta], None],
         stats_time_to_close: Union[dict[str, timedelta], None],
         stats_time_to_answer: Union[dict[str, timedelta], None],
         stats_time_in_draft: Union[dict[str, timedelta], None],
@@ -29,6 +30,7 @@
 def write_to_json(
     issues_with_metrics: Union[List[IssueWithMetrics], None],
     stats_time_to_first_response: Union[dict[str, timedelta], None],
+    stats_time_to_first_review: Union[dict[str, timedelta], None],
     stats_time_to_close: Union[dict[str, timedelta], None],
     stats_time_to_answer: Union[dict[str, timedelta], None],
     stats_time_in_draft: Union[dict[str, timedelta], None],
@@ -104,6 +106,15 @@ def write_to_json(
         med_time_to_first_response = stats_time_to_first_response["med"]
         p90_time_to_first_response = stats_time_to_first_response["90p"]
 
+    # time to first review
+    average_time_to_first_review = None
+    med_time_to_first_review = None
+    p90_time_to_first_review = None
+    if stats_time_to_first_review is not None:
+        average_time_to_first_review = stats_time_to_first_review["avg"]
+        med_time_to_first_review = stats_time_to_first_review["med"]
+        p90_time_to_first_review = stats_time_to_first_review["90p"]
+
     # time to close
     average_time_to_close = None
     med_time_to_close = None
@@ -155,16 +166,19 @@ def write_to_json(
     # Create a dictionary with the metrics
     metrics: dict[str, Any] = {
         "average_time_to_first_response": str(average_time_to_first_response),
+        "average_time_to_first_review": str(average_time_to_first_review),
         "average_time_to_close": str(average_time_to_close),
         "average_time_to_answer": str(average_time_to_answer),
         "average_time_in_draft": str(average_time_in_draft),
         "average_time_in_labels": average_time_in_labels,
         "median_time_to_first_response": str(med_time_to_first_response),
+        "median_time_to_first_review": str(med_time_to_first_review),
         "median_time_to_close": str(med_time_to_close),
         "median_time_to_answer": str(med_time_to_answer),
         "median_time_in_draft": str(med_time_in_draft),
         "median_time_in_labels": med_time_in_labels,
         "90_percentile_time_to_first_response": str(p90_time_to_first_response),
+        "90_percentile_time_to_first_review": str(p90_time_to_first_review),
         "90_percentile_time_to_close": str(p90_time_to_close),
         "90_percentile_time_to_answer": str(p90_time_to_answer),
         "90_percentile_time_in_draft": str(p90_time_in_draft),
@@ -193,6 +207,7 @@ def write_to_json(
                 "assignee": issue.assignee,
                 "assignees": issue.assignees,
                 "time_to_first_response": str(issue.time_to_first_response),
+                "time_to_first_review": str(issue.time_to_first_review),
                 "time_to_close": str(issue.time_to_close),
                 "time_to_answer": str(issue.time_to_answer),
                 "time_in_draft": str(issue.time_in_draft),
diff --git a/markdown_writer.py b/markdown_writer.py
index 4963987..49b0048 100644
--- a/markdown_writer.py
+++ b/markdown_writer.py
@@ -78,6 +78,10 @@ def get_non_hidden_columns(labels) -> List[str]:
     if not hide_time_to_first_response:
         columns.append("Time to first response")
 
+    hide_time_to_first_review = env_vars.hide_time_to_first_review
+    if not hide_time_to_first_review:
+        columns.append("Time to first review")
+
     hide_time_to_close = env_vars.hide_time_to_close
     if not hide_time_to_close:
         columns.append("Time to close")
@@ -129,6 +133,7 @@ def sort_issues(
     valid_fields = {
         "time_to_close",
         "time_to_first_response",
+        "time_to_first_review",
         "time_to_answer",
         "time_in_draft",
         "created_at",
@@ -200,6 +205,7 @@ def group_issues(
 def write_to_markdown(
     issues_with_metrics: Union[List[IssueWithMetrics], None],
     average_time_to_first_response: Union[dict[str, timedelta], None],
+    average_time_to_first_review: Union[dict[str, timedelta], None],
     average_time_to_close: Union[dict[str, timedelta], None],
     average_time_to_answer: Union[dict[str, timedelta], None],
     average_time_in_draft: Union[dict[str, timedelta], None],
@@ -268,6 +274,7 @@ def write_to_markdown(
         write_overall_metrics_tables(
             issues_with_metrics,
             average_time_to_first_response,
+            average_time_to_first_review,
             average_time_to_close,
             average_time_to_answer,
             average_time_in_draft,
@@ -345,6 +352,8 @@ def write_to_markdown(
                         )
                     if "Time to first response" in columns:
                         file.write(f" {issue.time_to_first_response} |")
+                    if "Time to first review" in columns:
+                        file.write(f" {issue.time_to_first_review} |")
                     if "Time to close" in columns:
                         file.write(f" {issue.time_to_close} |")
                     if "Time to answer" in columns:
@@ -374,6 +383,7 @@ def write_to_markdown(
 def write_overall_metrics_tables(
     issues_with_metrics,
     stats_time_to_first_response,
+    stats_time_to_first_review,
     stats_time_to_close,
     stats_time_to_answer,
     average_time_in_draft,
@@ -397,6 +407,7 @@ def write_overall_metrics_tables(
             column in columns
             for column in [
                 "Time to first response",
+                "Time to first review",
                 "Time to close",
                 "Time to answer",
                 "Time in draft",
@@ -417,6 +428,16 @@ def write_overall_metrics_tables(
                 )
             else:
                 file.write("| Time to first response | None | None | None |\n")
+        if "Time to first review" in columns:
+            if stats_time_to_first_review is not None:
+                file.write(
+                    f"| Time to first review "
+                    f"| {stats_time_to_first_review['avg']} "
+                    f"| {stats_time_to_first_review['med']} "
+                    f"| {stats_time_to_first_review['90p']} |\n"
+                )
+            else:
+                file.write("| Time to first review | None | None | None |\n")
         if "Time to close" in columns:
             if stats_time_to_close is not None:
                 file.write(
diff --git a/test_assignee_integration.py b/test_assignee_integration.py
index 1af28e6..ab7f3ff 100644
--- a/test_assignee_integration.py
+++ b/test_assignee_integration.py
@@ -54,6 +54,7 @@ def test_assignee_in_markdown_output(self):
         try:
             write_to_markdown(
                 issues_with_metrics=issues_with_metrics,
+                average_time_to_first_review=None,
                 average_time_to_first_response={
                     "avg": timedelta(hours=3),
                     "med": timedelta(hours=3),
@@ -132,6 +133,7 @@ def test_assignee_in_json_output(self):
         try:
             json_output = write_to_json(
                 issues_with_metrics=issues_with_metrics,
+                stats_time_to_first_review=None,
                 stats_time_to_first_response={
                     "avg": timedelta(hours=3),
                     "med": timedelta(hours=3),
diff --git a/test_column_order_fix.py b/test_column_order_fix.py
index 45fcfc6..54418b8 100644
--- a/test_column_order_fix.py
+++ b/test_column_order_fix.py
@@ -55,6 +55,7 @@ def test_status_and_created_at_columns_alignment(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=None,
+            average_time_to_first_review=None,
             average_time_to_close=None,
             average_time_to_answer=None,
             average_time_in_draft=None,
@@ -80,7 +81,7 @@ def test_status_and_created_at_columns_alignment(self):
         # The table should have the columns in the correct order
         # and the data should be properly aligned
         expected_header = (
-            "| Title | URL | Assignee | Author | Time to first response | "
+            "| Title | URL | Assignee | Author | Time to first response | Time to first review | "
             "Time to close | Time to answer | Created At | Status |"
         )
         self.assertIn(expected_header, content)
@@ -92,7 +93,7 @@ def test_status_and_created_at_columns_alignment(self):
             "| Test Issue | https://github.com/user/repo/issues/1 | "
             "[assignee1](https://github.com/assignee1) | "
             "[testuser](https://github.com/testuser) | 1 day, 0:00:00 | "
-            "2 days, 0:00:00 | 3 days, 0:00:00 | 2023-01-01T00:00:00Z | open |"
+            "None | 2 days, 0:00:00 | 3 days, 0:00:00 | 2023-01-01T00:00:00Z | open |"
         )
         self.assertIn(expected_row, content)
 
diff --git a/test_config.py b/test_config.py
index 280d588..bbb84e6 100644
--- a/test_config.py
+++ b/test_config.py
@@ -131,6 +131,7 @@ def test_get_env_vars_with_github_app(self):
             hide_time_to_answer=False,
             hide_time_to_close=False,
             hide_time_to_first_response=False,
+            hide_time_to_first_review=False,
             hide_created_at=True,
             hide_status=True,
             ignore_user=[],
@@ -187,6 +188,7 @@ def test_get_env_vars_with_token(self):
             hide_time_to_answer=False,
             hide_time_to_close=False,
             hide_time_to_first_response=False,
+            hide_time_to_first_review=False,
             hide_created_at=True,
             hide_status=True,
             ignore_user=[],
@@ -292,6 +294,7 @@ def test_get_env_vars_optional_values(self):
             hide_time_to_answer=True,
             hide_time_to_close=True,
             hide_time_to_first_response=True,
+            hide_time_to_first_review=False,
             hide_created_at=True,
             hide_status=True,
             ignore_user=[],
@@ -339,6 +342,7 @@ def test_get_env_vars_optionals_are_defaulted(self):
             hide_time_to_answer=False,
             hide_time_to_close=False,
             hide_time_to_first_response=False,
+            hide_time_to_first_review=False,
             hide_created_at=True,
             hide_status=True,
             ignore_user=[],
diff --git a/test_json_writer.py b/test_json_writer.py
index 3a6a24f..5924316 100644
--- a/test_json_writer.py
+++ b/test_json_writer.py
@@ -77,16 +77,19 @@ def test_write_to_json(self):
 
         expected_output = {
             "average_time_to_first_response": "2 days, 12:00:00",
+            "average_time_to_first_review": "None",
             "average_time_to_close": "5 days, 0:00:00",
             "average_time_to_answer": "1 day, 0:00:00",
             "average_time_in_draft": "1 day, 0:00:00",
             "average_time_in_labels": {"bug": "1 day, 16:24:12"},
             "median_time_to_first_response": "2 days, 12:00:00",
+            "median_time_to_first_review": "None",
             "median_time_to_close": "4 days, 0:00:00",
             "median_time_to_answer": "2 days, 0:00:00",
             "median_time_in_draft": "1 day, 0:00:00",
             "median_time_in_labels": {"bug": "1 day, 16:24:12"},
             "90_percentile_time_to_first_response": "1 day, 12:00:00",
+            "90_percentile_time_to_first_review": "None",
             "90_percentile_time_to_close": "3 days, 0:00:00",
             "90_percentile_time_to_answer": "3 days, 0:00:00",
             "90_percentile_time_in_draft": "1 day, 0:00:00",
@@ -106,6 +109,7 @@ def test_write_to_json(self):
                     "assignee": "charlie",
                     "assignees": ["charlie"],
                     "time_to_first_response": "3 days, 0:00:00",
+                    "time_to_first_review": "None",
                     "time_to_close": "6 days, 0:00:00",
                     "time_to_answer": "None",
                     "time_in_draft": "1 day, 0:00:00",
@@ -120,6 +124,7 @@ def test_write_to_json(self):
                     "assignee": None,
                     "assignees": [],
                     "time_to_first_response": "2 days, 0:00:00",
+                    "time_to_first_review": "None",
                     "time_to_close": "4 days, 0:00:00",
                     "time_to_answer": "1 day, 0:00:00",
                     "time_in_draft": "None",
@@ -136,6 +141,7 @@ def test_write_to_json(self):
             write_to_json(
                 issues_with_metrics=issues_with_metrics,
                 stats_time_to_first_response=stats_time_to_first_response,
+                stats_time_to_first_review=None,
                 stats_time_to_close=stats_time_to_close,
                 stats_time_to_answer=stats_time_to_answer,
                 stats_time_in_draft=stats_time_in_draft,
@@ -194,16 +200,19 @@ def test_write_to_json_with_no_response(self):
 
         expected_output = {
             "average_time_to_first_response": "None",
+            "average_time_to_first_review": "None",
             "average_time_to_close": "None",
             "average_time_to_answer": "None",
             "average_time_in_draft": "None",
             "average_time_in_labels": {},
             "median_time_to_first_response": "None",
+            "median_time_to_first_review": "None",
             "median_time_to_close": "None",
             "median_time_to_answer": "None",
             "median_time_in_draft": "None",
             "median_time_in_labels": {},
             "90_percentile_time_to_first_response": "None",
+            "90_percentile_time_to_first_review": "None",
             "90_percentile_time_to_close": "None",
             "90_percentile_time_to_answer": "None",
             "90_percentile_time_in_draft": "None",
@@ -223,6 +232,7 @@ def test_write_to_json_with_no_response(self):
                     "assignee": None,
                     "assignees": [],
                     "time_to_first_response": "None",
+                    "time_to_first_review": "None",
                     "time_to_close": "None",
                     "time_to_answer": "None",
                     "time_in_draft": "None",
@@ -237,6 +247,7 @@ def test_write_to_json_with_no_response(self):
                     "assignee": None,
                     "assignees": [],
                     "time_to_first_response": "None",
+                    "time_to_first_review": "None",
                     "time_to_close": "None",
                     "time_to_answer": "None",
                     "time_in_draft": "None",
@@ -253,6 +264,7 @@ def test_write_to_json_with_no_response(self):
             write_to_json(
                 issues_with_metrics=issues_with_metrics,
                 stats_time_to_first_response=stats_time_to_first_response,
+                stats_time_to_first_review=None,
                 stats_time_to_close=stats_time_to_close,
                 stats_time_to_answer=stats_time_to_answer,
                 stats_time_in_draft=stats_time_in_draft,
diff --git a/test_markdown_writer.py b/test_markdown_writer.py
index 29129f2..46b199f 100644
--- a/test_markdown_writer.py
+++ b/test_markdown_writer.py
@@ -103,6 +103,7 @@ def test_write_to_markdown(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=time_to_first_response,
+            average_time_to_first_review=None,
             average_time_to_close=time_to_close,
             average_time_to_answer=time_to_answer,
             average_time_in_draft=time_in_draft,
@@ -126,6 +127,7 @@ def test_write_to_markdown(self):
             "| Metric | Average | Median | 90th percentile |\n"
             "| --- | --- | --- | ---: |\n"
             "| Time to first response | 2 days, 0:00:00 | 2 days, 0:00:00 | 2 days, 0:00:00 |\n"
+            "| Time to first review | None | None | None |\n"
             "| Time to close | 3 days, 0:00:00 | 3 days, 0:00:00 | 3 days, 0:00:00 |\n"
             "| Time to answer | 4 days, 0:00:00 | 4 days, 0:00:00 | 4 days, 0:00:00 |\n"
             "| Time in draft | 1 day, 0:00:00 | 1 day, 0:00:00 | 1 day, 0:00:00 |\n"
@@ -137,13 +139,13 @@ def test_write_to_markdown(self):
             "| Number of items that remain open | 2 |\n"
             "| Number of items closed | 1 |\n"
             "| Total number of items created | 2 |\n\n"
-            "| Title | URL | Assignee | Author | Time to first response | Time to close | "
+            "| Title | URL | Assignee | Author | Time to first response | Time to first review | Time to close | "
             "Time to answer | Time in draft | Time spent in bug | Created At | Status |\n"
-            "| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n"
+            "| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n"
             "| Issue 1 | https://github.com/user/repo/issues/1 | [charlie](https://github.com/charlie) | "
-            "[alice](https://github.com/alice) | 1 day, 0:00:00 | 2 days, 0:00:00 | 3 days, 0:00:00 | "
+            "[alice](https://github.com/alice) | 1 day, 0:00:00 | None | 2 days, 0:00:00 | 3 days, 0:00:00 | "
             "1 day, 0:00:00 | 4 days, 0:00:00 | -5 days, 0:00:00 | None |\n"
-            "| Issue 2 | https://github.com/user/repo/issues/2 | None | [bob](https://github.com/bob) | 3 days, 0:00:00 | "
+            "| Issue 2 | https://github.com/user/repo/issues/2 | None | [bob](https://github.com/bob) | 3 days, 0:00:00 | None | "
             "4 days, 0:00:00 | 5 days, 0:00:00 | 1 day, 0:00:00 | 2 days, 0:00:00 | -5 days, 0:00:00 | None |\n\n"
             "_This report was generated with the [Issue Metrics Action](https://github.com/github-community-projects/issue-metrics)_\n"
             "Search query used to find these items: `is:issue is:open label:bug`\n"
@@ -223,6 +225,7 @@ def test_write_to_markdown_with_vertical_bar_in_title(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=average_time_to_first_response,
+            average_time_to_first_review=None,
             average_time_to_close=average_time_to_close,
             average_time_to_answer=average_time_to_answer,
             average_time_in_draft=average_time_in_draft,
@@ -244,6 +247,7 @@ def test_write_to_markdown_with_vertical_bar_in_title(self):
             "| Metric | Average | Median | 90th percentile |\n"
             "| --- | --- | --- | ---: |\n"
             "| Time to first response | 2 days, 0:00:00 | 2 days, 0:00:00 | 2 days, 0:00:00 |\n"
+            "| Time to first review | None | None | None |\n"
             "| Time to close | 3 days, 0:00:00 | 3 days, 0:00:00 | 3 days, 0:00:00 |\n"
             "| Time to answer | 4 days, 0:00:00 | 4 days, 0:00:00 | 4 days, 0:00:00 |\n"
             "| Time in draft | 1 day, 0:00:00 | 1 day, 0:00:00 | 1 day, 0:00:00 |\n"
@@ -255,14 +259,14 @@ def test_write_to_markdown_with_vertical_bar_in_title(self):
             "| Number of items that remain open | 2 |\n"
             "| Number of items closed | 1 |\n"
             "| Total number of items created | 2 |\n\n"
-            "| Title | URL | Assignee | Author | Time to first response | Time to close | "
+            "| Title | URL | Assignee | Author | Time to first response | Time to first review | Time to close | "
             "Time to answer | Time in draft | Time spent in bug | Created At | Status |\n"
-            "| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n"
+            "| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n"
             "| Issue 1 | https://github.com/user/repo/issues/1 | [charlie](https://github.com/charlie) | "
-            "[alice](https://github.com/alice) | 1 day, 0:00:00 | 2 days, 0:00:00 | 3 days, 0:00:00 | "
+            "[alice](https://github.com/alice) | 1 day, 0:00:00 | None | 2 days, 0:00:00 | 3 days, 0:00:00 | "
             "1 day, 0:00:00 | 1 day, 0:00:00 | -5 days, 0:00:00 | None |\n"
             "| feat| Issue 2 | https://github.com/user/repo/issues/2 | None | "
-            "[bob](https://github.com/bob) | 3 days, 0:00:00 | "
+            "[bob](https://github.com/bob) | 3 days, 0:00:00 | None | "
             "4 days, 0:00:00 | 5 days, 0:00:00 | None | 2 days, 0:00:00 | -5 days, 0:00:00 | None |\n\n"
             "_This report was generated with the [Issue Metrics Action](https://github.com/github-community-projects/issue-metrics)_\n"
         )
@@ -284,6 +288,7 @@ def test_write_to_markdown_no_issues(self):
                 None,
                 None,
                 None,
+                None,
                 report_title="Issue Metrics",
             )
 
@@ -310,6 +315,7 @@ def test_write_to_markdown_no_issues(self):
         "GH_TOKEN": "test_token",
         "HIDE_CREATED_AT": "False",
         "HIDE_TIME_TO_FIRST_RESPONSE": "True",
+        "HIDE_TIME_TO_FIRST_REVIEW": "True",
         "HIDE_TIME_TO_CLOSE": "True",
         "HIDE_TIME_TO_ANSWER": "True",
         "HIDE_LABEL_METRICS": "True",
@@ -379,6 +385,7 @@ def test_writes_markdown_file_with_non_hidden_columns_only(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=average_time_to_first_response,
+            average_time_to_first_review=None,
             average_time_to_close=average_time_to_close,
             average_time_to_answer=average_time_to_answer,
             average_time_in_draft=average_time_in_draft,
@@ -428,6 +435,7 @@ def test_writes_markdown_file_with_non_hidden_columns_only(self):
             "GH_TOKEN": "test_token",
             "HIDE_CREATED_AT": "False",
             "HIDE_TIME_TO_FIRST_RESPONSE": "True",
+            "HIDE_TIME_TO_FIRST_REVIEW": "True",
             "HIDE_TIME_TO_CLOSE": "True",
             "HIDE_TIME_TO_ANSWER": "True",
             "HIDE_LABEL_METRICS": "True",
@@ -490,6 +498,7 @@ def test_writes_markdown_file_with_hidden_status_column(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=average_time_to_first_response,
+            average_time_to_first_review=None,
             average_time_to_close=average_time_to_close,
             average_time_to_answer=average_time_to_answer,
             average_time_in_draft=average_time_in_draft,
@@ -538,6 +547,7 @@ def test_writes_markdown_file_with_hidden_status_column(self):
             "GH_TOKEN": "test_token",
             "HIDE_CREATED_AT": "False",
             "HIDE_TIME_TO_FIRST_RESPONSE": "True",
+            "HIDE_TIME_TO_FIRST_REVIEW": "True",
             "HIDE_TIME_TO_CLOSE": "True",
             "HIDE_TIME_TO_ANSWER": "True",
             "HIDE_LABEL_METRICS": "True",
@@ -601,6 +611,7 @@ def test_writes_markdown_file_with_hidden_items_list(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=average_time_to_first_response,
+            average_time_to_first_review=None,
             average_time_to_close=average_time_to_close,
             average_time_to_answer=average_time_to_answer,
             average_time_in_draft=average_time_in_draft,
diff --git a/test_sorting_grouping.py b/test_sorting_grouping.py
index a080750..d50d437 100644
--- a/test_sorting_grouping.py
+++ b/test_sorting_grouping.py
@@ -297,6 +297,7 @@ def test_write_to_markdown_with_sorting(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=None,
+            average_time_to_first_review=None,
             average_time_to_close=None,
             average_time_to_answer=None,
             average_time_in_draft=None,
@@ -357,6 +358,7 @@ def test_write_to_markdown_with_grouping(self):
         write_to_markdown(
             issues_with_metrics=issues_with_metrics,
             average_time_to_first_response=None,
+            average_time_to_first_review=None,
             average_time_to_close=None,
             average_time_to_answer=None,
             average_time_in_draft=None,
diff --git a/test_time_to_first_review.py b/test_time_to_first_review.py
new file mode 100644
index 0000000..bfbbf0d
--- /dev/null
+++ b/test_time_to_first_review.py
@@ -0,0 +1,63 @@
+"""Unit tests for the time_to_first_review module."""
+
+import unittest
+from datetime import datetime, timedelta
+from unittest.mock import MagicMock
+
+from time_to_first_review import measure_time_to_first_review
+
+
+class TestMeasureTimeToFirstReview(unittest.TestCase):
+    """Test the measure_time_to_first_review function."""
+
+    def test_measure_time_to_first_review_basic(self):
+        """Test that the function calculates correct review time."""
+
+        mock_issue = MagicMock()
+        mock_issue.created_at = "2023-01-01T00:00:00Z"
+
+        mock_review = MagicMock()
+        mock_review.submitted_at = datetime.fromisoformat("2023-01-02T00:00:00Z")
+
+        mock_pull_request = MagicMock()
+        mock_pull_request.reviews.return_value = [mock_review]
+
+        result = measure_time_to_first_review(mock_issue, mock_pull_request, None, [])
+
+        expected = timedelta(days=1)
+
+        self.assertEqual(result, expected)
+
+    def test_measure_time_to_first_review_no_reviews(self):
+        """Test that function returns None if there are no reviews."""
+
+        mock_issue = MagicMock()
+        mock_issue.created_at = "2023-01-01T00:00:00Z"
+
+        mock_pull_request = MagicMock()
+        mock_pull_request.reviews.return_value = []
+
+        result = measure_time_to_first_review(mock_issue, mock_pull_request, None, [])
+
+        self.assertEqual(result, None)
+
+    def test_measure_time_to_first_review_ignore_pending(self):
+        """Test that pending reviews are ignored."""
+
+        mock_issue = MagicMock()
+        mock_issue.created_at = "2023-01-01T00:00:00Z"
+
+        pending_review = MagicMock()
+        pending_review.submitted_at = None
+
+        valid_review = MagicMock()
+        valid_review.submitted_at = datetime.fromisoformat("2023-01-03T00:00:00Z")
+
+        mock_pull_request = MagicMock()
+        mock_pull_request.reviews.return_value = [pending_review, valid_review]
+
+        result = measure_time_to_first_review(mock_issue, mock_pull_request, None, [])
+
+        expected = timedelta(days=2)
+
+        self.assertEqual(result, expected)
diff --git a/time_to_first_review.py b/time_to_first_review.py
new file mode 100644
index 0000000..6fec968
--- /dev/null
+++ b/time_to_first_review.py
@@ -0,0 +1,92 @@
+"""Utilities for measuring time to first review for pull requests."""
+
+from datetime import datetime, timedelta
+from typing import List, Union
+
+import github3
+import numpy
+from classes import IssueWithMetrics
+from time_to_first_response import ignore_comment
+
+
+def measure_time_to_first_review(
+    issue: Union[github3.issues.Issue, None],
+    pull_request: Union[github3.pulls.PullRequest, None],
+    ready_for_review_at: Union[datetime, None] = None,
+    ignore_users: Union[List[str], None] = None,
+) -> Union[timedelta, None]:
+    """Measures duration between pull request creation time and the timestamp when the first review is submitted"""
+
+    if not issue or not pull_request:
+        return None
+
+    if ignore_users is None:
+        ignore_users = []
+
+    first_review_time = None
+
+    try:
+        reviews = pull_request.reviews(number=50)
+        for review in reviews:
+            if ignore_comment(
+                issue.issue.user,
+                review.user,
+                ignore_users,
+                review.submitted_at,
+                ready_for_review_at,
+            ):
+                continue
+
+            first_review_time = review.submitted_at
+            break
+
+    except TypeError as e:
+        print(
+            f"An error occurred processing review comments. Perhaps the review contains a ghost user. {e}"
+        )
+        return None
+
+    if first_review_time is None:
+        return None
+
+    if ready_for_review_at:
+        pr_created_time = ready_for_review_at
+    else:
+        pr_created_time = datetime.fromisoformat(issue.created_at)
+
+    return first_review_time - pr_created_time
+
+
+def get_stats_time_to_first_review(
+    issues: List[IssueWithMetrics],
+) -> Union[dict[str, timedelta], None]:
+    """Compute statistics (average, median, 90th percentile) for time to first review."""
+    review_times = []
+    none_count = 0
+    for issue in issues:
+        if issue.time_to_first_review:
+            review_times.append(issue.time_to_first_review.total_seconds())
+        else:
+            none_count += 1
+
+    if len(issues) - none_count <= 0:
+        return None
+
+    average_seconds_to_first_review = numpy.round(numpy.average(review_times))
+    med_seconds_to_first_review = numpy.round(numpy.median(review_times))
+    ninety_percentile_seconds_to_first_review = numpy.round(
+        numpy.percentile(review_times, 90, axis=0)
+    )
+
+    stats = {
+        "avg": timedelta(seconds=average_seconds_to_first_review),
+        "med": timedelta(seconds=med_seconds_to_first_review),
+        "90p": timedelta(seconds=ninety_percentile_seconds_to_first_review),
+    }
+
+    # Print the average time to first review converting seconds to a readable time format
+    print(
+        f"Average time to first review: {timedelta(seconds=average_seconds_to_first_review)}"
+    )
+
+    return stats