This article reviews the implications, issues, and challenges of agricultural cooperatives in rural development and the fight against rural exodus in Madagascar, with a particular focus on the Itasy and Analamanga regions. By collectively organizing small producers and facilitating their access to markets, cooperatives strengthen the economic resilience and autonomy of rural communities. However, their impact is limited by several factors, including a lack of financing, competition with large agribusiness companies, and difficulties in retaining members. The primary objective of the study is to identify how agricultural cooperatives can promote sustainable rural development in Madagascar while overcoming these challenges. The research question focuses on how these organizations can enhance their resilience and effectiveness in an uncertain economic environment. The literature suggests that practices such as participatory governance, economic inclusion, and capacity building can improve member retention and cooperative sustainability. To maximize their potential, this study recommends strategic actions such as improving access to financing, developing institutional partnerships, and adopting technological innovations.