Community health centers (CHCs) in Uganda play a critical role in providing healthcare services to underserved populations. However, their efficiency and cost-effectiveness remain underexplored. The review employed a comprehensive search strategy across multiple databases, including PubMed and African Journals Online. Studies were included if they utilised quasi-experimental methods for cost-effectiveness analysis (CEA) of CHC systems. Quasi-experimental studies found that CHCs in Uganda achieved significant cost savings without compromising service quality, with an average reduction in per-patient costs by 20% compared to traditional healthcare settings. This review underscores the importance of rigorous methodological approaches for evaluating CHC systems' effectiveness and sustainability in resource-limited settings. Future research should prioritise robust quasi-experimental designs with clear cost-benefit analyses, ensuring reliable conclusions about CHCs' role in improving healthcare access and affordability. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.