BACKGROUND: Women GPs experience higher rates of burnout, anxiety, depression, and slower career progression than men GPs. Women GPs are sought out by patients for specific conditions, which may increase consultation length. This can be a source of job satisfaction for some. However it can also contribute to additional exhaustion and affects career progression, meaning women GPs are at higher risk of leaving the profession. There is an urgent need to identify solutions to retain and support them. AIM: This review brings together a wide range of evidence to identify the conditions in which women GPs can thrive, to better support them at work. DESIGN AND SETTING: An international realist review of academic and grey literature across eight databases and Google Scholar. METHOD: Following a realist approach, supported by stakeholder and patient involvement, a range of published documents were analysed using a realist logic to identify how, why, for whom and in what circumstances women GPs thrive at work. RESULTS: A total of 72 documents are included in this review. Sixteen configurations describe the conditions in which women GPs can thrive. Results cover three concepts: 'Patient-facing work'; 'Navigating competing roles'; and 'Sustainable careers, leadership and success'. However, literature also places heavy reliance on encouraging women GPs to 'fix' their own circumstances. CONCLUSION: This review provides evidence-based recommendations which may be of interest to those responsible for organisational culture within general practices, including (but not limited to) GP partners, and women GPs, who can utilise the recommendations to influence change.