Despite ongoing efforts to improve faculty diversity, systemic barriers have historically marginalized racial and ethnic minorities, particularly women, in academic positions. This systematic review addresses a critical gap in the literature by synthesizing longitudinal trends in the racial and gender composition of academic faculty, shedding light on the evolution of these disparities over time. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, with a systematic search of five databases (Sociological Abstracts, APA PsycINFO, CINAHL, Gender Studies Database, and MEDLINE) conducted between 2014 and July 2024 without language restrictions. Of the 8,423 records initially identified, 52 peer-reviewed articles, predominantly from medical and health-related departments, met the inclusion criteria for review. Using the Joanna Briggs Institute critical appraisal checklist, the methodological design of most included articles was assessed as high quality. Key findings revealed a general increase in the representation of underrepresented in medicine (URiM) faculty in some fields but stagnation or decline in others, particularly at senior levels. An intersectional analysis of race and gender highlighted that URiM women face unique challenges, including lower promotion rates and higher attrition risks. While these findings point to some progress in the overall representation of URiM faculty, substantial inequities persist, particularly at leadership levels and in promotion and retention processes. These challenges are further exacerbated by intersectional factors. Future research should incorporate qualitative data to better understand barriers and guide the development of targeted interventions.