This Systematic Literature Review aims to investigate the extent to which the Realistic Mathematics Education (RME) approach contributes to improving the quality of mathematics learning at the elementary school level, while also filling the research gap in the absence of a comprehensive thematic synthesis of the effectiveness patterns of RME based on mathematics topics, grade levels, and dimensions of learning outcomes. The PRISMA 2020 protocol was used as the methodological framework. From three electronic databases, Google Scholar (89), ERIC (32), and Scopus (26), 147 articles were obtained (2014–2024). After applying inclusion and exclusion criteria, 25 articles were selected; methodological quality was assessed using MMAT (20 high quality, 5 moderate). The thematic synthesis revealed: (1) RME improves understanding of mathematical concepts (22/25 studies; d = 0.60–0.89); (2) RME improves problem-solving skills (19/25 studies; average 28%); and (3) RME has a positive effect on learning motivation (7/25 studies). RME has been shown to be effective across seven mathematics topics and across grades I–VI. Supporting factors for implementation include the selection of relevant, realistic contexts, teacher competence, the use of models and teaching aids, and the integration of digital technology. This review concludes that RME is an evidence-based approach worthy of recommendation, with limitations including varying study quality, potential publication bias, and the predominance of quasi-experimental designs.Keyword: RME, Learning Outcomes, Conceptual Understanding, Problem Solving