Background: Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide. While Helicobacter pylori is primarily a gastric pathogen, emerging evidence suggests potential extra-gastric manifestations, including possible links to respiratory diseases. However, the association between H. pylori infection and CAP remains poorly characterized. Objective: This systematic review aimed to critically evaluate and synthesize the available evidence regarding the association between Helicobacter pylori infection and community-acquired pneumonia. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science for publications from January 2021 to January 2026. Studies investigating direct or indirect associations between H. pylori infection and CAP were included. Eight studies met eligibility criteria, encompassing diverse designs including cohort, case-control, cross-sectional, and randomized controlled trials. Quality assessment was performed using appropriate tools (Newcastle-Ottawa Scale, JBI Checklist, Cochrane RoB 2). Results: Direct evidence for an H. pylori-CAP association was limited, with only three studies providing direct seroepidemiological or immunological data. These demonstrated that H. pylori infection may modulate systemic inflammatory responses (elevated CXCL10 and IL-10; reduced IL-1β and IL-6) and showed non-significant associations with respiratory pathogen co-exposure. Indirect evidence highlighted that proton pump inhibitor use—commonly prescribed for H. pylori-related conditions—was associated with significantly increased pneumonia risk (adjusted hazard ratio: 1.882 for long-term use). Studies in peptic ulcer patients reported postoperative pneumonia rates of 5–12%. Overall evidence quality was moderate, with significant heterogeneity precluding meta-analysis. Conclusion: Direct evidence linking H. pylori infection to community-acquired pneumonia is remarkably limited and inconclusive. The available data suggest that any association may operate through immunomodulatory mechanisms or indirect pathways, particularly proton pump inhibitor use. Well-designed prospective cohort studies with validated H. pylori diagnostics and adequate confounder adjustment are urgently needed to clarify this relationship.