Background: Many studies have been carried out to establish the effects of music therapy on behaviors of older adults with dementia with positive findings. However, the current evidence of the effects of music listening during mealtime on older adults with dementia is unclear, and information of implementation of music listening during mealtime for older adults is also limited. Objectives: This paper describes the evidence of the effects of mealtime music listening for those with dementia and to provide implications for implementation and practice. Methods: A review was undertaken by searching English and Chinese electronic databases with specified search terms for the period of 1994 2010. The Cochrane library, CINAHL, PubMed, and PsychInfo databases were searched. The search was limited to articles in the English and Chinese language and peer-reviewed journals. Randomised controlled trials and quasi-experimental studies that evaluated the effects of music listening or compared music listening with other interventions during mealtime for older adults with dementia were eligible for inclusion. Two reviewers independently carried out study selection, data extraction and quality assessment. Results: Seven research-based articles were included and all of these studies used quasi-experimental design. The majority of the studies used relaxing classical music and did not indicate whether or not the music was familiar or preferred by the participants. Only one study specifically used pleasant familiar music for those with dementia. All studies reported that music listening during mealtime influenced the behaviors of older adults with dementia in a positive way by reducing the occurrence of agitated behaviors. One study specifically evaluated mealtime music listening on feeding problems and reported significant improvement on feeding problems, food intake, and nutrition status of those with dementia. However, the small sample sizes and lack of randomisation in these studies mean that caution is needed in drawing conclusions. Conclusions: This review concludes that music listening during mealtime has the potential in reducing agitated behaviors and improving feeding problems of those with dementia. However, the evidence of the effect of mealtime music listening for older adults with dementia is not strong due to some methodological limitations in the reviewed studies. There is a need for further research using more rigorous research designs with comparison groups. Music listening with relaxing or pleasant familiar music is an inexpensive, accessible, and non-invasive non-pharmacological intervention which is suitable to be used for older adults during their mealtimes at home or in long-term care facilities. Social, cultural, and environmental factors need to be considered while implementing music therapy for older adults during mealtime. The presence of familiar music during mealtime can be used to introduce the sense of familiarity into a new environment and may stimulate their remote memories associated with positive feelings. Music that elicits positive memories from the past will have a soothing effect on those with dementia, which would further reduce agitation. Incorporation of familiar music listening during mealtime has the potential to provide a therapeutic approach to manage behavioural problems and feeding problems of older adults with dementia and improve their quality of life.