Inappropriate antibiotic use in food animals is considered a significant contributor to increasing antibiotic resistance. Consumers can play a critical role in reducing it through purchasing choices, demand, and policy advocacy. This systematic review aimed to synthesize all published literature investigating consumers' perspectives (i.e., knowledge, perceptions, and attitudes) on antibiotic use and antibiotic resistance in food animals. We conducted a comprehensive literature search in PubMed, Web of Science, Scopus, and Google Scholar on November 14, 2022, and an updated search on April 30, 2024. We limited findings to original peer-reviewed journal articles published up to 2023 (inclusive), were written in English, and focused on knowledge/perceptions/attitudes of antibiotic use and antibiotic resistance in food animals. Of the 3815 articles identified, 39 were included. The findings suggested that consumers were concerned about antibiotic use in food animals, thus they were willing to pay more for food products with antibiotic-free or reduced-antibiotic use. However, consumers lacked deep understanding of antibiotic use practice and antibiotic stewardship in food animals as well as transmission risks of antibiotic-resistant bacteria. These findings offer valuable insights for policymakers and livestock industries to implement policy and practice changes to ensure responsible antibiotic use in food animals.