Recently, with the development of communication and positioning technologies, progressively higher demands have been placed on the timeliness of indoor communication and the effectiveness of indoor positioning. This paper proposes a low-cost and full-time domain coverage indoor communication and localization fusion system that uses an infrared camera to identify mobile LEDs based on region of interest optical camera communication (RoI-OCC) and calculate three-dimensional (3D) world coordinates based on perspective-n-point (PnP) algorithm. An intermediate delimiter modulation-demodulation method is designed to achieve asynchronous OCC. In processing infrared images, a region-growth-based absolute-directional-mean-difference (RG-ADMD) algorithm is developed to detect infrared targets and recover the scale. Additionally, a local-contrast-method-based Lucas-Kanade (LCM-LK) optical flow estimation algorithm is designed to track infrared targets and determine the centroid coordinates of pixels. In a 5×5 m experimental area, the established system can achieve a target detection recall rate of over 85%, the asynchronous OCC with error-free transmission and an average 3D positioning accuracy of 2.01 cm under a LCM-LK tracking algorithm.