Background <p>Several studies have demonstrated that potent sociocognitive factors, particularly perceived race, strongly influence empathy leading to altered social interactions, especially in clinical settings. This systematic review aimed to clarify how racial bias influences brain responses to others’ pain.</p> Methods <p>For this review, 17 eligible studies included based a systematic search of PubMed, Scopus, Embase, and Web of Science for this review. All included studies utilized event-related potentials to investigate the neural correlates of empathy for pain in visual empathy judgment tasks.</p> Results <p>Early event-related potential (ERP) components, such as P1 and N170, reflect initial processing biases in racial pain judgment. The P2 component highlights automatic emotional biases, evidenced by enhanced neural responses to same-race suffering. Finally, the flexible P3 component indicates higher-level cognitive appraisal and controlled processing, influenced by individual beliefs and social context. These ERP findings are consistent with neurocognitive models that involve brain networks involved in salience recognition (e.g., anterior cingulate cortex, insula) and top-down regulation (e.g., dorsolateral prefrontal cortex) and are aligned with theoretical frameworks, such as predictive coding theory and dual-process theories.</p> Conclusions <p>Reviewed ERP evidence provides a precise neurocognitive time course of how racial bias shapes empathic pain processing. Distinct ERP components reveal a progression from rapid perception (e.g., P1, N170) to automatic affective bias (P2) and later cognitive appraisal (P3). These findings underscore empathy as a dynamic and flexible process, amenable to targeted interventions. This neurophysiological insight establishes a promising foundation for developing strategies to motivate prosocial behavior, challenge discrimination, and advance equity.</p>