Background: This was a systematic review presenting the future competencies for hospital managers. Methods: Participants, interventions, comparisons and outcomes (PICO) strategy with MeSH terms were used for searching. Databases used were Web of Science, PsycINFO and Medline, EBSCO, ScienceDirect, Emerald, ProQuest, Social Sciences Research Network, Embase, and some Iranian database such as IRANDOC and SID. All publications were accepted if they had been published in English or Persian language and fulltexts were accessible. The study was carried out using a systematic literature search published between January 1995 and December 2018. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications were carried out independently by two reviewers using the Critical Appraisal Skills Programme (CASP) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A descriptive summary with data tables produced to summarize the literature. Data extraction was conducted by two researchers.Results: Forty seven studies were analyzed to identify the future competencies required for hospital managers. In all, 3190 publications were retrieved. 1934 citations were excluded because of irrelevant (n=2600), duplicates (n=316), and unavailable full text (n=18). After studying the 256 remaining publications, 33 citations were extracted and presented. After extracting the future competencies of hospital managers, competencies were classified into four main categories based on the qualitative meta-synthesis process. Conclusion:The most important competencies in the future are global knowledge, Key Eligibility Criteria, wide attitude and core skills that must be addressed in the face of ambiguity.