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Background: An ageing population has resulted in increased numbers of older adults moving to a nursing home, and the challenges triggered by relocation are highlighted. Various factors are identified to be associated with relocation and psychological adjustment to living in a nursing home. However, no systematic review has synthesised the evidence, and its associated factors remain unclear., Objective: To examine and synthesise the best available evidence on the factors associated with adjustment to living in a care facility., Design: Systematic review., Data Sources: Nine electronic databases were searched from database inception to March 2020: Pubmed, Embase, CINAHL, PsycINFO, Cochrane library, China National Knowledge Infrastructure, China Wanfang Database, Chinese Biomedical Literature Database, Chinese Periodical Full-text Database., Review Methods: The references listed in the included studies were manually checked. The quality of the eligible studies was assessed using the 11-item checklist of the Agency for Healthcare Research and Quality., Results: A total of 20 studies were included in this review, with 17 cross-sectional studies, and three longitudinal study. 19 studies were rated as moderate quality and the other one was high quality. 17 measures were used to assess nursing home adjustment. Six distinct categories of the associated factors for nursing home adjustment were identified: demographic characteristics (n = 11), physiological factors (n = 3), psychological factors (n = 9), social factors (n = 9), relocation factors (n = 6), and facility factors (n = 5)., Conclusions: Decision-making control, self-efficacy, social support, activities of daily living, and length of stay should all be taken into account when assisting resident scoping with a relocation to a nursing home. Infuture research, multiple areas can be considered when improving the level of nursing home adjustment, as well as interventions and health policies., Registration Number: PROSPERO CRD 42018115935., Tweetable Abstract: A systematic review of the factors associated with adjustment to living in a care facility., Competing Interests: Conflict of Interest None., (Copyright © 2020. Published by Elsevier Ltd.)