Throughout human history, domestic animal species have represented a unique zoonotic disease risk for the transmission of pathogens ranging from viral, bacterial, parasitic, and fungal. In North Africa, cats have a particularly long record and occupy a specialized niche within many communities. This systematic review was conducted to analyze the current and historical literature documenting the breadth and variety of zoonoses in North Africa, specifically relating to the domesticated feline. Multiple electronic databases were searched on January 16, 2019, for published reports on feline zoonoses in North Africa. A total of 76 studies met the inclusion criteria for a full assessment. Articles selected for the review ranged in publication dates from 1939 to 2019 and included a case study, cross-sectional surveys, genomic analyses, and a book chapter. The most commonly studied pathogen was Toxoplasma gondii (n = 17) followed by a variety of helminths (n = 10). Of the countries in the target region, most publications were of studies conducted in Egypt (n = 53) followed by Tunisia (n = 12), Algeria (n = 11), Morocco (n = 5), and Libya (n = 3). The results of this review identify a variety of viral, bacterial, fungal, and parasitic zoonotic diseases associated with cats in North Africa, ranging from historically endemic diseases in both human and animal populations in the region, to emerging infections with recent confirmatory diagnoses. This review describes reported feline zoonoses in North Africa and provides recommendations for their prevention and control. In addition to vaccination campaigns for domesticated felines and postexposure prophylaxis for humans, prompt veterinary and medical care of exposure risks and subsequent infections are essential in limiting the zoonotic disease burden in North African communities of humans and cats.