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Obesity is one of the largest public health issues facing the United States today, with $173 billion spent on obesity-related diseases annually. One known contributor to the issue is the food environment, which characterizes community food access. The most referenced food environments are food deserts and food swamps, but the interaction of these is understudied. This review assessed the effect of food swamps and deserts on diet quality and obesity rates. Although previous studies have evaluated this relationship in US children, this is the first review to our knowledge that addresses US adults. A search was conducted in two databases: PubMed and Scopus. All studies compared food deserts and food swamps; however, studies either assessed diet quality, obesity, or diet quality and obesity. Eleven studies were included in this review, with eight assessing obesity and five assessing diet quality. A statistically significant association between food swamps and increased risk of obesity was found in eight studies. Four studies found a statistically significant association between food swamps and diet quality, while one did not. Food deserts had more varied results, with studies finding a statistically significant association with increased risk of obesity and three not. Five studies did not significantly associate food deserts with diet quality, and one study found a statistically weak association. These results indicate that food swamps are a stronger, more consistent predictor of diet quality and obesity. A more systematic view of food environments, specifically food swamps, will be necessary for future policy efforts.