Limited and judicious antimicrobial usage (AMU) is considered the key to saving the success of human and veterinary medicine in treating infections. With the limited alternatives for antimicrobials, farm biosecurity (and herd management) is considered a promising tool to mitigate the non-judicious AMU and to maintain animal health, production, and welfare. The present scoping review aims to analyse the effect of farm biosecurity on AMU in livestock systems and formulate recommendations. Peer-reviewed manuscripts published between 2001–2022 were analyzed using the PRISMA framework using PubMed, Scopus, and Science Direct databases. After applying the inclusion criteria, 27 studies were found to assess the effect of farm biosecurity (or management practices) on AMU at the herd/farm level in quantitative/semi-quantitative terms. These studies were carried out in 16 countries, of which 74.1% (20/27) were from 11 European countries. The highest number of studies were from pig farms [51.8% (14/27)], followed by poultry (chicken) farms [25.9% (7/27)], cattle farms [11.1% (3/27)], and a single study from a turkey farm. Two studies include both pig and poultry farms. Most of the studies were cross-sectional [70.4% (19/27)], seven were longitudinal, and one was a case-control study. Complex interactions were observed among factors influencing AMU, such as biosecurity measures, farm characteristics, farmers’ attitudes, availability of animal health services, stewardship, etc. A positive association between farm biosecurity and reduction in AMU was observed in 51.8% (14/27) of the studies, and 18.5% (5/27) showed that improvement in farm management practices was associated with a reduction in AMU. Two studies highlighted that coaching and awareness among farmers might lead to a decrease in AMU. A single study on economic assessment concluded biosecurity practices as a cost-effective way to reduce AMU. On the other hand, five studies showed an uncertain or spurious association between farm biosecurity and AMU. We recommend the reinforcement of the concept of farm biosecurity, especially in lower- and middle-income countries (LMICs). Further, there is a need to strengthen the evidence on the association between farm biosecurity and AMU in region- and species-specific farm settings.