This review explores the current landscape of artificial intelligence (AI)-assisted semi-automation tools used in systematic reviews and guideline development. With the exponential growth of medical literature, these tools have emerged to improve efficiency and reduce the workload involved in evidence synthesis. Platforms such as Covidence, EPPI-Reviewer, DistillerSR, and Laser AI exemplify how machine learning and, more recently, large language models (LLMs) are being integrated into key stages of the systematic review process—ranging from literature screening to data extraction. Evidence suggests that these tools can save considerable time, with some achieving average reductions of over 180 hours per review. However, challenges remain in transparency, reproducibility, and validation of AI performance. In response, international initiatives such as the Responsible AI in Evidence Synthesis (RAISE) project and the Guideline International Network (GIN) have proposed frameworks to ensure the ethical, trustworthy, and effective use of AI in health research. These include principles like transparency, accountability, preplanning, and continuous evaluation. This review highlights both the opportunities and limitations of adopting AI in evidence synthesis and underscores the importance of human oversight and rigorous validation to ensure that such tools enhance, rather than compromise, the integrity of systematic reviews and guideline development.