The education of autistic children presents significant challenges, compelling various educational stakeholders to seek solutions that can enhance teaching and learning experiences for these individuals. Among the most promising strategies are gameful approaches, including gamification, card games, and simulators. Despite recent efforts, understanding the development and application (i.e., the state of the art) of these approaches in the education of autistic children remains a complex task. To address this issue, we conducted a thorough systematic literature review and scientometric analysis to explore the design and implementation of gameful approaches for the education of children with autism. Our findings highlight the predominant use of 2D games designed for personal computers, focusing on natural, home, and urban settings. Additionally, we observed that the studies were primarily qualitative. Based on these results, we proposed a research agenda. We offer a comprehensive overview and a research agenda for the design, use, and assessment of gameful approaches in the education of children with autism.