Empowerment interventions facilitate individuals, organisations and communities to gain better control over their health. They are distinctly different from traditional behaviour-change models and encourage participants to set their own health priorities and agenda. Current evidence suggests empowerment interventions are efficacious for smoking, sexual and mental health outcomes. However, empowerment in childhood obesity (which remains a global public health challenge) is under-researched. This review systematically analysed the evidence for empowerment approaches in childhood weight management. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A search strategy was applied to six databases from inception to 14th May 2020. Evidence was appraised using The Academy of Nutrition and Dietetics Quality Criteria Checklist and National Health and Medical Research Council Levels of Evidence. Of the 8,405 papers identified, 29 papers describing 14 programs met the inclusion criteria. Twenty-five studies rated positive and four rated neutral. Overall, the evidence body rated ‘B’. 72% of the 3318 participants were from priority populations, highlighting the unique ability of empowerment interventions to engage those most in need. Results demonstrate small to large improvements in participant body mass index with effect sizes ranging from 0.08 to 1.13. Which, in some age groups, was more efficacious than current behaviour-change approaches. For diet and physical activity, outcomes were not able to be grouped due to heterogeneity in their measurement. However, results were comparable to current literature, highlighting empowerment as an alternative option to traditional approaches. Throughout the literature, empowerment was measured inconsistently and usually with a surrogate marker. All studies were set in America or Canada. This review suggests empowerment should be further investigated in childhood weight management. Empowerment interventions represent a unique opportunity to meaningfully integrate self-determination to clinical childhood weight management practice and overcome current barriers related to priority population engagement.