Background: With the widespread use of electronic devices, visual fatigue has become a prevalent issue in modern society. Non-pharmacological interventions, such as facial massage and exercise, have been proposed as effective methods for alleviating visual fatigue. However, the specific effects and mechanisms behind these interventions require further exploration. Objectives: This systematic review aims to evaluate the effectiveness of facial massage and exercise in reducing visual fatigue and to explore the underlying mechanisms of these interventions. Methods: A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, Scopus, and the Cochrane Library. Randomized controlled trials and crossover experiments were included for both quantitative and qualitative analyses of relevant studies. Results: The findings suggest that both facial massage and exercise can reduce visual fatigue. Facial massage alleviates eye strain by stimulating the parasympathetic nervous system, reducing stress and anxiety, relaxing muscles, and improving blood circulation. Exercise alleviates visual fatigue through two mechanisms: (1) enhancing overall blood circulation, reducing stress, improving sleep quality, and overall health; (2) directly exercising eye muscles through eye yoga, which helps relieve visual fatigue. Conclusions: Preliminary research indicates that facial massage, full-body exercise, and eye yoga hold potential as non-pharmacological interventions for visual fatigue. Eye yoga has experimental support for its ability to strengthen eye muscles and improve focus. Massage stimulates parasympathetic activity and boosts blood circulation, while full-body exercise enhances systemic circulation to relieve eye fatigue. Future research should focus on investigating the mechanisms of these interventions in more detail and comparing the effects of various types, intensities, and durations to provide more precise clinical recommendations.