Qualitative studies contain in-depth information about facilitators and barriers to successful rehabilitation. This systematic review synthesised findings across qualitative studies to inform vocational rehabilitation practices for people who have experienced burn injury. PRISMA guidelines were used to determine inclusion criteria for the review and develop a comprehensive search strategy. Four databases were searched and results screened. Included studies investigated experiences of return to work (RTW) or meaningful activity in a burn injury population. Quality of included articles was examined using the CASP framework for qualitative research. Thematic synthesis was used to analyse the qualitative results. Six studies met inclusion criteria. Five analytic themes were identified regarding experiences of vocational support and ability to RTW after burn injury: addressing the complex impact of burn injury; personal connections as vital support; skilled and specialised healthcare as central to RTW; value of knowledge; and considering the work environment. No included studies investigated meaningful activity other than paid work. Findings support structured vocational rehabilitation, psychological interventions, social support, intensive rehabilitation and patient, clinician and workplace education as key in facilitating RTW after burn injury. Additionally, coordinated care is likely to improve vocational outcomes. Research is needed on supporting return to meaningful activity.