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Aim: This qualitative systematic review aimed to consolidate existing evidence on the self‐management experience of older patients with multimorbidity worldwide. Methods: Nine databases were searched, for papers published from database inception to April 2023. The systematic review was conducted according to the systematic review method of qualitative evidence by the Joanna Briggs Institute (JBI). Results: Seven studies were included. Finally, four themes and 12 subthemes were formed: (1) physical level: reduced physical function and lack of coordinated care; (2) psychological level: mental state of anxiety and positive attitude towards life; (3) social level: technical support, support from family, support from healthcare workers and support from others; and (4) practical level: economic burden, lifestyle changes, self‐care in daily life and compliance was much lower than expected. Conclusions: To improve self‐management in older people with multimorbidity, nurses should provide more guidance to patients to improve their self‐management skills, and clinicians should recommend effective self‐management behaviours. Summary statement: What is already known about this topic?: Globally, approximately 50% of older people aged over 65 years demonstrate multimorbidity, with sharp increases in the prevalence in this population.In recent years, the phenomenon of older people with multimorbidity has received increasing attention, and there has been an increase in the number of related qualitative studies. While these studies provide an in‐depth account of experiences among samples, synthesizing these findings can help identify similarities and differences, as well as gaps in current knowledge. Therefore, there is a need for systematic evaluation and meta‐integration of the results of multiple qualitative studies to obtain deeper, more comprehensive findings. What the paper adds to existing knowledge?: The practice of self‐management in older patients with multimorbidity should include the physical, psychological, social and practical levels of the patient.As the primary providers of health services, nurses should sensitize older patients with multimorbidity to the susceptibility and severity of their disease and help them to improve their self‐management skills.Clinicians need to recommend effective self‐management behaviours to implement into the daily lives of older patients with multimorbidity in their clinical practice. What are the implications for practice?: These findings remind us that clinical healthcare professionals should be patient‐centred and focus on the personal experience of self‐management in older adults with multimorbidity.Findings emphasize the need for healthcare professionals to focus on diversifying management strategies and the need to provide targeted self‐management guidance to older patients with multimorbidity to help them improve their self‐management skills. [ABSTRACT FROM AUTHOR]