Background: Researchers within transdisciplinary fields examine physical literacy; however, substantial changes have been suggested regarding the evaluation and reporting of physical literacy within health education. Purpose: This systematic review provides an overview of a) physical literacy literature published in the U.S.; b) scholars, disciplines, and contexts represented in available U.S-based physical literacy studies; and c) explicates the progression of physical literacy in the U.S. over the last 20 years. Methods: Utilizing the PRISMA-P 2015, 36 manuscripts met the inclusion criteria. Results: Concepts such as health, education, activity, school, development, life, competence, and knowledge were strongly related to physical literacy. Most reviewed studies operationalized the physical literacy construct, applied physical literacy elements to various health and educational contexts, provided overviews and assessments of curricula and program interventions, or delineated between definitions and understandings of physical literacy. Discussion: Constructive debate continues over the meaning, purpose, and outcomes of physical literacy, allowing future research endeavors to bridge existing philosophical and pragmatic perspectives by testing new evidence-based interventions. Translation to Health Education Practice: This study exposes gaps in knowledge to inform Certified Health Education Specialists (CHES) on how to successfully conceptualize physical literacy in various educational contexts.