Background: Social issues have short- or long-term as well as positive or negative effects on health systems. Identifying and analyzing events and trends help managers to make the vision and strategic planning. The purpose of this study is to identify the social trends and their impacts on the future of the Iranian health system. Methods: Focus group discussion (FGD) was used to collect the data in 2017--18. The participants were selected through purposive sampling and the snowball method. The discussions were all written and recorded with the consent of the participants. A qualitative content analysis was used to analyze the data. Results: The participants believed that the most important social trends affecting future of health system in Iran are increase health literacy, demographic transition, nutritional pattern, migration and urbanization, marginal settlement, rising unemployment, and increased usage of personal cars. Conclusions: The increase in health problems, healthcare costs, and mortality because of social behaviors and trends are considered as threats to the health system. Therefore, policymakers should reduce their negative effects by taking into account and focusing on these trends and making appropriate plans.