Background: Human papillomavirus (HPV) vaccination is a cornerstone of cervical-cancer prevention, but acceptance, intention and actual uptake remain uneven in Nigeria. Women attending tertiary health-care facilities are important information recipients, caregivers and decision-makers for vaccination of eligible daughters and wards. This review synthesises evidence relevant to knowledge, awareness and multilevel determinants of HPV vaccine acceptance, with particular interpretive emphasis on Nasarawa State and comparable North-Central Nigerian settings. Objective: To systematically identify and synthesise evidence on knowledge, awareness, acceptance, willingness, uptake and determinants of HPV vaccination among women, mothers, caregivers and closely related adult decision-makers in Nigeria, and to determine the implications for women attending tertiary health-care facilities in Nasarawa State. Methods: The review was structured in accordance with PRISMA 2020 and informed by Joanna Briggs Institute evidence-synthesis principles. The search strategy was expanded into reproducible database-specific syntax for PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL and African Journals Online (AJOL). The formal search cut-off was 30 August 2026. Accessible indexed records and publisher/database pages were rechecked during the September 2026 update, and recent Nigerian primary studies and systematic reviews were incorporated into the evidence map. Eligibility covered quantitative, qualitative and mixed-methods studies involving women, mothers, caregivers or relevant adult decision-makers, with outcomes involving HPV knowledge, awareness, acceptance, willingness, hesitancy or uptake. Because subscription databases cannot be queried through this environment with an authenticated institutional account, exact hit counts for Embase, Scopus, Web of Science and CINAHL are not fabricated; the manuscript therefore provides the complete reproducible search strings and a transparent