Currency notes are essential components of our day-to-day activities as they play great roles in our transactions. However, they have continued to serve as media of exchange of pathogenic microorganisms and parasites. The naira note has been greatly mishandled by Nigerians over the years, and this has led to the circulation of dirty, contaminated, and mutilated notes. This systematic review was carried-out to provide an up-to-date summary of the public health risks associated with contaminated naira notes. This systematic review was conducted and reported in conformation with the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols 2015 (PRISMA-P) statements and checklists. Databases (PubMed, AJOL, and Google Scholar) were searched for published articles on the microbial and parasitic contamination of naira notes. A total of 26 studies were analyzed for this review. The studies majorly reported high microbial contamination in lower denomination naira notes (N10 and N100). The pathogens from naira notes reported in the studies include Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Salmonella typhi, Vibrio cholera, Aspergillus niger, and Blastomyces dermatitidis. Eggs and cysts of Ascaris lumbricoides eggs, hookworm, lice of the genus Pediculus humanus corporis, Enterobius vermicularis, flagellates, and Entamoeba histolytica were reported in the studies. A high degree of resistance of bacterial pathogens from naira notes to commonly used antibiotics was also observed in this study. Currency notes serve as fomites for the transfer of pathogenic microorganisms and parasites. Most of the organisms reported in this study have been implicated in human infections including food-borne infections, urinary tract infections, and respiratory infections. Good hygiene and proper education of Nigerians on the public health risks posed by mishandling naira notes should be done to reduce the spread of pathogens and parasites through naira notes.