Systems and methods for autonomously dispensing items. A dispensing system receives a first distributed ledger transaction that: i) identifies an item, ii) identifies a container associated with and containing the item, iii) includes a status indicator in a first state identifying the item as present in the container, and iv) includes an authorization code associated with a mobile device. The authorization code is received from the mobile device. The dispensing system creates a second distributed ledger transaction based on the first distributed ledger transaction that changes the status indicator to a second state identifying the item as authorized for dispensing. Responsive to the creation of the second distributed ledger transaction, access is autonomously provided to the item. The dispensing system creates a third distributed ledger transaction based on the second distributed ledger transaction that changes the status indicator to a third state identifying the item as dispensed.