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Purpose Specialist perinatal mental health services identify and treat women experiencing mental health conditions during pregnancy and up to one year post birth. There is limited knowledge about women’s experiences of care from specialist services. Evaluation and optimisation of service delivery requires knowledge of women’s care experiences. This review aimed to systematically identify, appraise, and synthesise qualitative evidence exploring women’s experiences of specialist perinatal mental health services. Methods A systematic literature search of fve databases: Medline (OVID), EMBASE (Elsevier), PsycINFO (EBSCO), CINAHL (EBSCO) and Scopus (Elsevier), grey literature searching, and backward citation, identifed a total of 1035 papers of which sixteen met inclusion criteria. Methodological quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) tool. Results Thematic synthesis identifed three themes: connected relationships; new beginnings; and meaningful service delivery. Findings identifed that relationships developed with clinicians were signifcant to women and their experience of care. Women valued continuity of care from dedicated non-judgemental clinicians. Peer support from other mothers was perceived as meaningful to women. Through service interventions women gained new insights into their infant’s needs and grew in confdence as a mother. Conclusions Women require provision of fexible and accessible specialist services with clinicians who are sensitive to their individual psychosocial needs and preferences. Examining discharge practices and continuing care needs is essential to ensure the best outcomes for women and their families.