Biofortified crops offer a promising solutions to combat micronutrient deficiencies, particularly in developing nations. This study undertakes a systematic review of farmer-level acceptance and adoption of biofortified crops, including the key determinants, methodologies, indicators and measures, and findings related to acceptance and adoption of biofortified crops among farmers. The review identified 24 biofortification studies with farmers conducted across Africa and Asia, primarily in countries such as Nigeria, Uganda, and Tanzania. These studies focus on biofortified crops like rice, banana, cassava, and sweet potato. Notably, a majority of the reviewed studies followed a quantitative approach and employed a cross-sectional design. The key outcome indicators encompassed farmers’ willingness-to-pay, perceptions, beliefs, willingness-to-plant in the next growing season, and the actual adoption itself. These indicators were typically measured using a 5-point Likert scale or a dummy variable. The primary determinants driving farmers to cultivate biofortified crops were classified into four categories: socioeconomic, institutional, agronomic, and psychological and cognitive factors. Given the complex nature of challenges like hidden hunger, an all-encompassing approach is imperative in seeking effective solutions. Understanding the intricate interplay between these factors, which shape the acceptance and adoption of biofortified crops, becomes pivotal in formulating strategies that effectively address this multifaceted issue. To address challenges like hidden hunger, comprehensive solutions are essential. Understanding the factors shaping the adoption of biofortified crops is crucial for effective strategies.