Communicable diseases such as COVID-19 have emerged as a serious threat to residents of residential aged care (RAC) facilities. Given that the RAC’s residents are already at an increased health risk due to their ages, exposure to COVID-19 increases their vulnerabilities. RACs, supposedly safe havens for the aged populations, may be putting their residents at higher risk due to poorly designed facilities. Accordingly, there is a dire need to investigate the RACs’ design features and improve the building layouts. The current study examines the impact of RAC facilities’ architectural design on mitigating COVID-19 transmission in RACs through a systematic literature review (SLR) guided by preferred reporting items for systematic reviews and meta-analysis (PRISMA) technique. Scholarly databases, including Scopus and Web of Science, were used to retrieve 34 relevant articles. VOSviewer was used to conduct bibliometric analysis followed by detailed content analyses. The findings exhibit that the primary design and environmental factors (spatial layouts, ventilation rate, airflow patterns, and outdoor spaces) can reduce infectious disease transmission in RACs. Architectural designs and spatial layouts, including Green Care or Household models, were viable built-up interventions to curtail the COVID-19 spread. Recommendations are provided for architects, policymakers, and facility managers to utilize building design with adequate ventilation, green walls, open spaces, and thermal comfort to control COVID-19 sprawl in RACs.