Blockchain technology (BCT) has emerged as a powerful solution to address critical challenges in the Industrial Internet of Things (IIoT), particularly enhancing data security, ensuring interoperability across systems, and improving transparency in transactions. Although BCT’s potential is widely recognized in various industries, including healthcare, its deployment in IIoT is complex due to several influencing factors. This systematic review examines the adoption models, challenges, and future directions for BCT within the IIoT context. It explores key concepts and models essential for understanding BCT integration in IIoT, such as the Technology Acceptance Model (TAM), Innovation Diffusion Theory, and theories of trust and transparency. These frameworks provide a comprehensive approach to evaluating the implementation procedures of BCT in IIoT. The findings of this study shed light on the current state of BCT implementation in IIoT, identifying challenges especially regulatory barriers, operational issues, and data privacy concerns. Additionally, the study emphasizes the need for specific regulations to ensure durability and safety. The insights from this review aim to guide researchers and practitioners in navigating the complexities of BCT adoption in IIoT, offering a itinerary for future research and implementation strategies.