Background: There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care, and methods for undertaking such syntheses are developing quickly. However, proponents of many of these methods set their developments against ‘traditional’ systematic reviews. The question therefore arises: in what ways can the synthesis of qualitative research be systematic? Objectives: To present methods and tools that support systematic practices in synthesising qualitative research. To question whether it is possible – or desirable – to eliminate subjectivity and interpretation. Results: Methods of synthesising qualitative research are presented, supported by quality assessment, quality assurance and information systems. They are discussed in the context of principles that underpin systematic reviews, and areas of commonality and difference are identified. Some concepts, such as sensitivity analysis, can be seen to applying to all types of review. Others, such as conceptual innovation and the development of reviewer interpretation, would appear to diverge from those found in more traditional systematic reviews. Methods and tools for being systematic and critical when synthesising qualitative research are described together with mechanisms for making areas of reviewer interpretation and bias explicit to potential users of reviews. Conclusions: It is possible to be highly systematic when conducting qualitative synthesis. Moreover, tools and software are available to support the synthesis of qualitative research in a way that upholds expected standards of rigour and transparency. However, as with systematic reviews of trials, being systematic does not necessarily remove subjectivity from the process, and it is arguable as to whether this is always desirable in these syntheses. For qualitative syntheses, this can be both a strength and a potential weakness.