The ability to detect and regulate one’s emotions is critical for decision-making, especially decision-making involving values and morals. This systematic review investigates the impact of ventromedial prefrontal cortex (vmPFC) damage on decision-making abilities, specifically comparing the performance of people with vmPFC injury and healthy controls in emotional response-based decision-making tasks. Two databases, MedlineEBSCO and Web of Science, were utilized to find literature, with a focus on articles published in English within the past 30 years. According to the seven studies that fulfilled the inclusion criteria, individuals with vmPFC impairment exhibit poorer decision-making ability than healthy controls, especially when it comes to decisions requiring emotional reactions. Nevertheless, there is disagreement in the literature on the issue regarding the mechanisms by which impairment in decision-making is mediated.