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This paper aims to review and examine the qualitative research literature on women in the illicit drug economy and to identify and integrate key themes using the technique of qualitative metasynthesis. A search of citation lists and online bibliographic databases identified a total of 36 studies, 15 of which met the inclusion criteria of generating findings in relation to female participation using qualitative or ethnographic research methods. Results suggest that the drug economy is a gender-stratified labor market and that while women draw on a diverse range of economic and social resources, including informal sector networks such as those involved in sex work, family, and community and welfare networks, most women in most drug markets remain confined to low-level and marginal roles.