Small-scale distributed gasification can provide energy access for low-carbon sustainable development, though current understanding of the economic and environmental performance of the technology relies mostly on assumption-heavy modeling studies. Here we report a detailed empirical assessment and uncertainty estimation for four real-world gasification power systems operating at rice mills in rural Cambodia. System inputs and outputs were characterized while operating in both diesel and dual-fuel modes and synthesized into a model of carbon and energy balance, economic performance, and greenhouse gas mitigation. Our results confirm that the best-performing systems reduce diesel fuel use by up to 83%, mitigating greenhouse gas emissions and recouping the initial system capital investment within one year. However, we observe a significant performance disparity across the systems observed leading to a wide range of economic outcomes. We also highlight related critical sustainability challenges around the management of byproducts that should be addressed before more widespread implementation of the technology.