Background: Organ donation and transplantation can save or improve the quality of life of people worldwide. However, there are many challenges associated with organ donation, as the demand for organs greatly outstrips supply. Additionally, there are brain-dead patients who could be potential organ donors. It is thus important to determine the attitudes affecting organ donation and transplantation in intensive care unit settings. Aim: this study aimed to identify attitudes that might affect organ donation and transplantation in intensive care unit settings. Methodology: Five electronic databases (CINAHL, Medline, PsycINFO, Scopus, and EMBASE) were searched systematically. A systematic search strategy was formulated. The quality of each study was assessed using the MMAT quality appraisal tool. Results: A total of seven studies were included. The findings of this systematic review demonstrate that education, policy, and continuing professional development could help to address barriers to donation. Conclusions: therefore, to influence organ donation and transplantation positively, the main themes evaluated in this systematic review provide an opportunity to influence organ donation and transplantation attitudes in intensive care unit settings.