Introduction: This study aimed to systematically review the existing evidence on the role of health literacy in strengthening health equity and health system resilience and to identify emerging trends, challenges, and future perspectives in this field.

Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive search was performed in PubMed, Scopus, Web of Science, Google Scholar, and the Persian databases SID and Magiran for studies published between 2015 and 2026. Keywords related to “health literacy,” “health equity,” “health system resilience,” “digital health literacy,” and “health-literate organizations” were used. After removing duplicates and screening studies based on predefined inclusion and exclusion criteria, eligible studies were selected. Study quality was assessed using standardized appraisal tools, and data were synthesized and analyzed through thematic analysis.

Results: Of the 1,247 records initially identified, 86 studies were ultimately included in the final analysis. The findings demonstrated that health literacy influences health equity and health system resilience at the individual, organizational, and policy levels. Emerging trends included the expansion of digital health literacy, the development of health-literate organizations, and a shift from individual responsibility toward systemic and policy-oriented approaches. Moreover, low health literacy was associated with social inequalities, the digital divide, inequitable access to healthcare services, and increased vulnerability during crises. Studies further indicated that countries investing in health literacy and strengthening communication and educational infrastructures exhibited greater resilience in responding to crises such as the COVID-19 pandemic.