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Abstract The goal of engineering the microbiome of the built environment is to create places and spaces that are better for human health. Like other emerging technologies, engineering the microbiome of the built environment may bring considerable benefits but there has been a lack of exploration on its societal implication and how to engineer in an ethical way. To date, this topic area has also not been pulled together into a singular study for any systematic review or analysis. This study fills this gap by providing the first a systematic review of societal and ethical implications of engineering microbiomes and the application of this knowledge to engineering the microbiome of the built environment. To organize and guide our analysis, we invoked four major ethical principles (individual good/non-maleficence, collective good/beneficence, autonomy, and justice) as a framework for characterizing and categorizing 15 distinct themes that emerged from the literature. We argue that these different themes can be used to explain and predict the social and ethical implications of engineering the microbiome of the built environment that if addressed adequately can help to improve public health as this field further develops at global scales.