This systematic scoping review synthesizes 42 studies to examine gender and leadership in Confucian societies. Rather than treating Confucianism as deterministic constraint, the analysis reveals how institutional mechanisms and legal frameworks produce divergent outcomes across East Asia. Women increasingly demonstrate leadership effectiveness through organizational performance and policy outcomes, yet this competence paradoxically fails to generate institutional recognition or advancement. The review identifies critical gaps between formal gender equity policies and substantive power redistribution, revealing that symbolic representation frequently masks hierarchical exclusion. Comparative analysis across Taiwan, Japan, South Korea, and Mainland China establishes that gender inequality persists through occupational segregation, policy inertia, and naturalization of male dominance. Findings challenge narratives attributing disparities to cultural values alone, instead implicating institutional actors’ deliberate reproduction of gendered power distributions.