Purpose There has been growing awareness underpinned with legislative recognition of the need to reduce the stigma attached to mental health. Education is seen as an integral factor for this endeavour. The purpose of this paper is to review existing literature to determine both positive and negative attitudinal changes of health-care-related undergraduate students towards mental illness after a training intervention within higher education. Design/methodology/approach A search of papers written in the English Language was conducted between 2004 and 2021, using CINAHL, Eric, Educational Research Complete, Medline, psychINFO and SocIndex. Search terms used were undergraduate, attitudes or perceptions, mental illness/mental ill health, education, stigma and students. Findings In total, 24 studies were critically reviewed, which included experimental, descriptive and exploratory designs. The appraisal of papers used recognised evaluation tools to review the methodological quality. Findings suggest that overall, anti-stigma education has a significant positive effect for student attitudinal change. Research limitations/implications Mental health anti-stigma education is beneficial for changing attitudes, however, more bio-medically framed training is less powerful for initiating change. Learning from those with the lived experience appears to have a more sustainable impact as indicated in some of the studies. There is a need for more exploratory research to gain further knowledge on the critical educational mechanisms that may foster more long-term reframing of positive attitudes towards mental health. Practical implications Training providers need to consider the compelling evidence base surrounding anti-stigma pedagogy that supports the use of individuals with experience of mental ill health within the educational processes. Social implications Mental health stigma has potential for profound negative impact on individuals and at a wider societal level. Education is central to enable learners to consider their attitudes to mental illness to reduce stigmatising attitudes. Students on health-care-related courses are influential in becoming catalysts for change. Originality/value This paper has critically reviewed the literature examining the attitudes of health-care-related undergraduate students following anti-stigma education, offering insights into some of positive and negative attitudinal changes and opinions of the event. In particular contributing to an understanding on the important components for eradicating the stigma surrounding mental health.