To facilitate the clinical guideline (GL) development process, different groups of researchers have proposed tools that enable computer-supported tools for authoring and publishing GLs. In a previous study we interviewed GL authors in different Norwegian institutions and identified tool shortcomings. In this follow-up study our goal is to explore to what extent GL authoring tools have been evaluated by researchers, guideline organisations, or GL authors. This article presents results from a systematic literature review of evaluation (including usability) of GL authoring tools. A controlled database search and backward snow-balling were used to identify relevant articles. From the 12692 abstracts found, 188 papers were fully reviewed and 26 papers were identified as relevant. The GRADEPro tool has attracted some evaluation, however popular tools and platforms such as DECIDE, Doctor Evidence, JBI-SUMARI, G-I-N library have not been subject to specific evaluation from an authoring perspective. Therefore, we found that little attention was paid to the evaluation of the tools in general. We could not find any evaluation relevant to how tools integrate and support the complex GL development workflow. The results of this paper are highly relevant to GL authors, tool developers and GL publishing organisations in order to improve and control the GL development and maintenance process.