Postpartum contraception is important for the health of women living with HIV, aiding in the prevention of unintended pregnancies and vertical transmission. The combined oral contraceptive (COC) pill is a common method, but its use concurrently with antiretroviral therapy (ART) in the postpartum period involves specific considerations that require clearer evidence within local contexts. This systematic review aimed to synthesise evidence on the rates of uptake and continuation of the combined oral contraceptive pill among postpartum women with HIV on ART, specifically within clinic settings in Kampala, Uganda. A systematic literature review was conducted. Electronic databases were searched for relevant peer-reviewed studies. Predefined inclusion and exclusion criteria were applied. Eligible studies were critically appraised, with data extracted and synthesised narratively. The review found a scarcity of high-quality studies focused specifically on this topic. Available evidence suggested that COC uptake in this population was low. One identified study reported a continuation rate below 30% at six months postpartum. Recurrent themes influencing use included patient and provider concerns about drug interactions, experienced side effects, and a clinical bias towards recommending long-acting reversible contraceptive methods. Evidence on COC use among postpartum women with HIV on ART in Kampala is limited. The existing data indicate suboptimal uptake and continuation, suggesting a potential shortfall in the range of supported contraceptive options for this group. Further robust, prospective studies are required to accurately measure COC use and its determinants in this population. Clinical programmes should provide comprehensive contraceptive counselling that includes accurate, evidence-based information on COC-ART interactions to facilitate informed reproductive choice. postpartum contraception, combined oral contraceptive, HIV, antiretroviral therapy, Uganda, systematic review This review consolidates the limited evidence on a specific contraceptive issue for a key population, identifying critical knowledge gaps to inform future research and clinical practice in this setting.