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Understanding youth perspectives is important for developing sustainable healthcare systems in Africa. In Côte d'Ivoire, a large youth population exists alongside medical sector reforms. A synthesis of young people's views on the future of medicine within this specific context is absent. This systematic review aimed to identify, synthesise, and critically appraise published literature on the perspectives of Ivorian youth regarding the future of medicine and healthcare in their country. A systematic search was conducted across multiple electronic databases and Ivorian university repositories. Peer-reviewed articles, reports, and theses published in English or French were included. Studies were screened against pre-defined eligibility criteria. Data were extracted and analysed using a narrative synthesis approach. From 18 included studies, a prominent theme was the high value placed on medical specialisation and advanced technology. Youth perspectives were strongly influenced by concerns over brain drain, a desire for improved medical education infrastructure, and the integration of digital health tools. The literature contained no empirical, quantitative data on future projections. Ivorian youth envision a future for medicine centred on technological advancement and specialist practice. Their views underscore significant structural concerns within the current system that must be resolved to realise this vision and retain professional talent. Future research should employ primary, prospective methodologies to capture youth visions. Policymakers and medical educators should engage directly with youth stakeholders to align training programmes and health system planning with these identified aspirations and concerns. Youth perspectives, future of medicine, healthcare, Côte d'Ivoire, medical education, systematic review, Africa This review provides the first consolidated synthesis of Ivorian youth perspectives on the future of medicine, establishing a foundation for future research and policy dialogue.