This article examines the interplay between international law norms on women’s reproductive rights and South African reproductive health case law. The author first summarizes key elements of abortion rights and reproductive health in international human rights laws such as CEDAW and CESCR. The author then sets out two approaches to defining reproductive autonomy that can be adopted in a given region’s legal system, including court cases. The first is a “reproductive choice” approach that is negative because it fails to dismantle societal norms, attitudes, and structural barriers that impede women’s reproductive autonomy. The second, preferred by the author, is a “reproductive justice” approach that centres disadvantaged women within a commitment to the structural transformation of society. The author then examines the contemporary court system in South Africa, determining that its courts currently use a reproductive choice approach. The author uses a particular South African court case as a basis for re-imagining the jurisprudence within a reproductive justice approach. Finally, they reflect on the usefulness of such court cases as transformative tools of reproductive justice because they can secure better implementation of abortion legislation for disadvantaged women.