PURPOSE: Black perinatal people in the United States are disproportionately affected by morbidity and mortality. An emerging hypothesis is that these disparities may be in part due to poor communication in obstetric care which may lead to poor perinatal care quality and adverse health outcomes. The purpose of this review is to provide a systematic review of the literature on patient-clinician communication amongst Black patients in perinatal healthcare settings. METHODS: A literature search was conducted for studies published between January 2006 to December 2024 using PubMed, PsycINFO, and Web of Science. PRISMA guidelines were followed to extract relevant articles and study methodologies and results were synthesized. RESULTS: A total of 11 qualitative and 18 quantitative studies met inclusion criteria. Overall, findings indicate reliable evidence of Black patients' reports of discrimination, being left out of decision-making, and being ignored by their clinicians. We discuss methodological limitations of the work and suggest improvements. CONCLUSION: The results of this review may inform interventions to target the quality of communication between perinatal clinicians and their Black patients to improve morbidity and mortality outcomes.