Background: Protein-Energy Malnutrition (PEM) is a significant public health issue, particularly in rural areas where access to adequate nutrition is often limited. This systematic review examines the efficacy of various nutritional interventions aimed at reducing PEM among rural children and assesses the outcomes of these interventions. Methods: A systematic review was conducted using databases such as PubMed, Cochrane Library, and Google Scholar. Studies published between January 2000 and December 2023 were included if they evaluated nutritional interventions targeting PEM in rural children aged 6 months to 5 years. The PRISMA guidelines were followed, and data were extracted on intervention types, study populations, and outcomes. Results: A total of 25 studies met the inclusion criteria. The interventions included supplementation with ready-to-use therapeutic foods (RUTF), micronutrient powders (MNPs), fortified complementary foods, community-based nutrition education, and agricultural interventions. The majority of studies reported a significant reduction in the prevalence of PEM following these interventions. The most effective interventions were those that combined direct supplementation with community education programs, leading to improved nutritional status, growth outcomes, and reduced morbidity and mortality rates. Conclusion: Nutritional interventions are effective in reducing PEM among rural children, especially when they include both direct nutritional support and community-based education. However, the sustainability of these interventions and their long-term impact require further research. Integrating agricultural practices with nutrition education could enhance the efficacy of these programs