The empowerment of women in rural areas implies that they have power and control over their lives and participate in individual and collective decision-making. Empowerment depends on autonomy or the ability to act independently. The lack or weakness of autonomy is due to traditional gender roles in rural communities, which reinforce norms and expectations that restrict women, limiting their empowerment and ability to make informed and effective decisions. This context fosters the creation of unequal power structures and women’s dependence on male figures. This article explores the relationship between autonomy and decision-making capacity in rural women. Through a review using the PRISMA approach, we analysed whether the absence of autonomy limits empowerment and decision-making. A total of 141 records were identified, and after excluding duplicate documents, those with no relation to the population and the purpose of this article, 35 articles with research results were included in this review. The categories addressed were empowerment, autonomy, decision-making and sustainable development, the latter emerging in the reviewed literature.