Agri-Food Supply Chain Network Design (AFSCND) is a growing field of research, as it has been and continues to be crucial in ensuring food security. In modern supply chain design, strategic decisions increasingly reflect the interaction between profit-driven enterprises and sustainability-focused regulatory bodies. Despite the existence of several review papers, a systematic review that synthesizes and analyzes recent contributions to the design of agri-food supply chain networks, as a strategic decision, within a framework emphasizing perishability modeling, sustainability, resiliency, and the role of Artificial Intelligence (AI) is still needed. This paper aims to fill this gap by focusing on how the literature addresses (i) strategic decisions and their coordination with either the tactical, the operational levels, or both, within forward or closed-loop supply chains (CLSCs); (ii) perishability modeling, a critical characteristic of many agri-food products; (iii) solution approaches, key decision variables, and uncertainty modeling; and (iv) the integration of AI techniques at the strategic level of network design. By evaluating the interplay among these elements, our objective is to provide a clear overview of current advancements, identify research gaps, and propose future directions for designing sustainable and resilient agri-food supply chains.