Global governance challenges highlight the role of international institutions as problem-solving structures. Institutional design is, more than ever, relevant in this context. The academic literature on this issue is characterized by the existence of consolidated debates such as that of rationalism vs. constructivism, with a focus on making specific contributions to the rational design of international institutions. Koremenos, Lipson, and Snidal (2001) elaborated upon a series of cause-effect conjectures linking cooperation problems, considered independent variables, with institutional design features, considered dependent variables. This research aims to highlight the empirical evidence of the existing debate on this work by conducting a systematic review. Twenty-one quantitative research studies were collected through a screening and selection procedure and were subject to systematization. The findings showed asymmetric approaches to the rational design project, and agreements were the type of international institution that received the most attention from academia. Rationalism was supported by most of the body of literature. However, a broad subgroup of articles complemented this rational approach with other variables or schools of thought, such as those of constructivism and historical institutionalism. The results have relevance for the international institution design literature, as future avenues of potential research are underlined.