BackgroundPublic institutions have the opportunity to implement environmental sustainability policies through leveraging their buying potential. Given the role of hospitals within the food system, the implementation of sustainable initiatives into hospital foodservices is a priority. Compared to conventional agricultural methods, organic food production uses more sustainable practices and warrants consideration for utilisation in hospitals. This systematic review aimed to synthesise the published literature to identify benefits, limitations and implementation issues regarding the use of organic foods in hospital foodservice settings.MethodsThe review protocol was prospectively published (PROSPERO registration CRD42022322245) and reported consistent with Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines. A systematic search of four databases was undertaken for papers published from January 2000 to March 2022; key outcome data were extracted and synthesised. Study quality was assessed using the Quality Criteria Checklist for Primary Research or the Critical Appraisal Skills Programme checklist.ResultsAfter review of 4102 titles/abstracts and 113 full‐text papers, the final library comprised 10 papers of moderate to high quality. The implementation of organic foods increased quality in addition to environmental sustainability improvements. The price premium, additional production requirements, change to kitchen routines and concerns with food quality and security of supply were reported as barriers. Government targets for increasing organic food, organisational support, and staff knowledge and training supported implementation.ConclusionsThis review identified opportunities for the implementation of organic foods into hospital foodservices, but there are numerous barriers to be overcome through strategies including organisational support and staff training.