Women in West Africa experience unique vulnerabilities to food insecurity due to structural and cultural drivers rooted in gendered social norms. We aimed to systematically review and synthesise available evidence describing the extent of food insecurity among women in West Africa, focusing on prevalence, drivers, and gender inequalities. Global Health, MEDLINE, Web of Science, Academic Search Complete, and Scopus were searched from year 2000 up until 2023 for quantitative and qualitative studies reporting data on the prevalence or drivers of food insecurity among women (independently of or in comparison to men) in West Africa. Thirty-two studies identified from four West African countries (Nigeria, Ghana, Côte d’Ivoire, Benin) met the inclusion criteria. About 24% of women experienced food insecurity in Côte d’Ivoire, 33–52% in Ghana, and 23–75% in Nigeria. In Benin, a study using the Household Food Insecurity Experience Scale (HFIES) reported a mean score of 3.2. Female-headed households had a higher prevalence of food insecurity than male-headed households. Key drivers of food insecurity among women included age (mixed findings across studies), low education, larger households, women’s income level, adhering to traditional gender roles, being single or widowed, assets owned, access to and control over productive and agricultural resources (land, capital), and autonomy. Food insecurity among women in parts of West Africa is high in prevalence, with significant gender inequalities. Targeted interventions to improve women’s access to resources, education, and economic opportunities, while addressing restrictive gender norms, should be prioritised.