Cockroaches serve as mechanical vectors for medically important pathogens, and their presence in hospitals is a common occurrence. Describe the pathogens and their resistance mechanisms carried by cockroaches collected in hospitals in different parts of the world during the period 2000-2023. This will be achieved through a systematic review of the indexed literature. The studies were identified through a search of the Google Scholar search engine and in electronic databases related to health: LILACS, Scielo Regional, and PubMed. The search strategy was conducted in accordance with the principles for systematic reviews and meta-analysis (PRISMA). The review encompassed 22 studies conducted during the specified period. Blattella germanica and Periplaneta americana are referenced in 15 and 13 of the analyzed studies, respectively. A variety of pathogens, including bacteria, fungi, protozoa, helminths, and rotavirus, were isolated and identified from the external and internal body parts of cockroaches. Bacteria represent the most frequently identified group. The species that appear most frequently in the selected articles are Escherichia coli (11 articles), Staphylococcus aureus (9 articles), Klebsiella pneumoniae (7 articles), and Pseudomonas aeruginosa (6 articles). E. coli and S. aureus bacteria were found to be resistant to antibiotics in 19% and 12% of articles, respectively. Conventional techniques, including seeding in culture media, Gram staining (GS), conventional biochemical tests (CBT), direct parasitological methods, and disc diffusion, have historically been the primary methods for identifying microorganisms and determining antibiotic susceptibility profiles in bacteria. However, there is a paucity of studies that use molecular tech-niques for bacterial identification and resistance mechanism detection. The identification of pathogens carried by cockroaches collected in hospitals suggests a potential risk of these insects in the transmission of healthcare-associated infections.