Effective communication is critical to team performance but can be impacted by the distribution of team members. Distribution is increasingly found in high-risk environments where task complexity necessitates geographic and/or temporal separation of team members. Understanding the impact of distribution on communication is critical to ensuring effective team performance. We review the research examining communication in distributed teams in high-risk environments to provide an overview of the literature to date. Articles examining communication in distributed teams were analyzed in a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Themes relevant to the research question were extracted from the studies using thematic analysis. Five themes were identified: updating shared mental models, effects of transmission lags, content of communication, communication protocols, and technological advances. The five themes identify directions for future research.