<p>Managed aquifer recharge (MAR) is a versatile approach that can help reduce vulnerability to climate change. In developing countries, where the need for adaptation is high, MAR often does not move beyond the experimental or piloting phase. This paper presents a systematic review of the challenges of implementing MAR in developing countries. Supplying developing countries with an overview of potential implementation barriers can enable them to consider these in feasibility studies to save time and financial implications later on in the process. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2000 methodology was applied to review academic articles and reports of managed aquifer recharge from the International Groundwater Resources Assessment Centre (IGRAC)’s Global MAR Portal (306 cases identified) and from a search for academic papers using four databases (483 documents identified). Fifty-three documents were included in the review. Implementation challenges were grouped into 11 categories. “Site-specific research, planning and technical issues” and “enabling policy frameworks” were the two most cited implementation challenges. This review further shows the interconnectedness between the 11 categories in terms of cause and effect. MAR efforts in developing countries are not well documented, particularly not in the scientific space. Notably, more than half of the papers included in this systematic review have at least one author from an institution in a developed country. Such international cooperation could facilitate knowledge exchange and local skills development, but it could also be indicative of dependence on international knowledge and financial aid for MAR implementation in developing countries.</p>