Over the last few years, business simulation games (BSGs) in higher education have attracted attention. BSGs tend to actively engage students with course material, promoting higher engagement and motivation and enabling learning outcomes. Increasingly, researchers are trying to explore the full potential of these games with an upsurge of research in the BSG field in recent years. There is a need to understand the current state of research and future research opportunities; however, there is a lack of recent systematic literature reviews in BSG literature. This study addresses this gap by systematically compiling online empirical research from January 2015 to April 2022. We followed PRISMA guidelines to identify fifty-seven (57) papers reporting empirical evidence of the effectiveness of BSGs in teaching and learning. Findings showed that BSGs improve learning outcomes such as knowledge acquisition, cognitive and interactive skills, and behaviour. The review also summarises different issues concerning the integration of BSGs into the curriculum, learning theories used in the selected studies, and assessment methods used to evaluate student achievement in learning outcomes. The findings of this review summarise the current research activities and indicate existing deficiencies and potential research directions that can be used as the basis for future research into the use of BSGs in higher education.