Living in compact neighbourhoods that are walkable, well connected, with accessible green space can benefit physical and mental health. However, the pandemic raises concern that higher population density may increase transmission of Covid-19, leading some to question the policy of high-density or 15 min neighbourhoods. We conducted a systematic review to identify, appraise and synthesise evidence reporting associations between transmission of respiratory viruses, including Covid-19, and dwelling or population density or other features of neighbourhood design. Twenty-one studies met our inclusion criteria. These studies used differing measures of neighbourhood design, and their findings were inconsistent. No clear conclusion can be drawn about any association between compact neighbourhood design and transmission of infection.