The proportion of people who change their metaphysical beliefs after psychedelic experiences is not yet known with specificity. However, it appears that belief changes can occur in some cases, and evidence more precisely estimating the prevalence and magnitude of such belief changes is accruing. The evidence for metaphysical belief changes is reviewed and the potential psychological mechanisms involved are considered. Some historical and contemporary philosophical work relevant to the topic as is briefly reviewed and some relevant clinical guidelines are described. Philosophically informed recommendations are made for research and clinical contexts in which psychedelic induced belief changes of this kind may occur.