This systematic review investigates the transformative impact of Healthcare 4.0 (HC4.0) technologies on healthcare service quality (HCSQ), focusing on their potential to enhance healthcare delivery while addressing critical challenges. This study reviewed 168 peer-reviewed articles from the Scopus database, published between 2005 and 2023. The selection process used clearly defined inclusion and exclusion criteria to identify studies focusing on advanced technologies such as artificial intelligence (AI), the Internet of Things (IoT), and big data analytics. Rayyan software facilitated systematic organization and duplicate removal, while manual evaluation ensured relevance and quality. The findings highlight HC4.0’s potential to improve service delivery, patient outcomes, and operational efficiencies but also reveal challenges, including interoperability, ethical concerns, and access disparities for underserved populations. The results were synthesized descriptively, uncovering key patterns and thematic insights while acknowledging heterogeneity across studies. Limitations include the absence of a formal risk-of-bias assessment and the diversity of methodologies, which precluded quantitative synthesis. This review emphasizes the need for future research on integration frameworks, ethical guidelines, and equitable access policies to realize HC4.0’s transformative potential. No external funding was received, and no formal protocol was registered.