Foodborne illnesses caused by microorganisms pose a significant threat to public health. Understanding the survival and persistence of these microorganisms in various food matrices is crucial for developing effective control strategies. This systematic review aims to address the current knowledge gaps related to the duration of survival and persistence of microbial pathogens in food, as well as the impact of external environmental conditions on their viability. A comprehensive search was conducted across major databases, including studies published until 3 June 2024. The PRISMA guidelines were followed to ensure a systematic and transparent approach. Foodborne bacteria, such as spp., , and O157:H7, were found to persist for extended durations, ranging from days to over a year. The mean duration of persistence for all of the bacteria was 246 days, whereas the survival duration was 16 days. Bacterial survival and persistence were significantly influenced by temperature, with warmer conditions (>25 °C) generally supporting longer persistence. Relative humidity also played a role, with low-humidity environments (<50% RH) favouring the survival of pathogens like and . In contrast, viruses, such as hepatitis A virus and Human norovirus, showed only survival patterns, with average durations of 21 days and temperature being the primary environmental factor influencing their survival. Overall, this review provides evidence that a wide range of microbial pathogens, including O157:H7, spp., , and the hepatitis A virus, can survive and persist in food for prolonged periods, leading to potential harm. These insights underscore the necessity of stringent food safety measures and continuous monitoring to mitigate the risks posed by these resilient pathogens, contributing to a safer and more secure food supply chain.