While injuries sustained from body armour backface deformation (BFD) have not been well-documented in military injury trauma registries, data from US law enforcement officers, animal tests and currently available data pertaining to military combatants has shown that BFD can not only cause minor injuries, but also result in serious trauma. However, the nature and severity of injuries sustained depends on a multitude of factors including the projectile type, the impact location and velocity, and the specific type of body armour worn. The difficulties involved in current measurement techniques for ballistic testing has led researchers to seek alternative techniques to evaluate the level of protection from body armour, such as the finite element (FE) method. In the current study, a systematic review of the open literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The aim was to summarise the literature pertaining to the development and application of FE models to investigate body armour BFD and behind armour blunt trauma (BABT), and included FE models representing the projectile, clay-based mediums, ballistic gelatine and the human torso. Using the keywords 'behind armour*', 'ballistic blunt trauma', 'BABT', 'backface signature', 'backface deformation', 'BFS', 'BFD', 'wound ballistic', 'ballistic impact testing', 'body armour', 'bullet proof vest', 'ballistic vest', 'Finite Element*' and 'FE', an electronic database search of EBSCOhost, Google Scholar, ProQuest, Scopus, Standards, Web of Science and PubMed was conducted, and included peer-reviewed journal articles, review papers, research reports, conference papers, and MSc or PhD theses. While this research demonstrates the potential of FE analysis for recreating realistic blunt impact scenarios and enhancing the current understanding of BABT mechanisms, a common limitation in most studies is the lack of validation. Thus, in order to address this issue, it is proposed that injury predictions from FE models be correlated with trauma data from soldiers who have sustained BABT. Consequently, pressure and energy distributions within the organs can be used to interpret the effects of non-penetrating ballistic impacts on the human torso. Bridging the gap between simulation and real-world data is essential in order to validate FE models and enhance their utility in optimising body armour design and employing injury mitigation strategies.