BACKGROUND With the advent of internet-based communications, face-to-face interactions are becoming increasingly uncommon and inconvenient, including those between the doctor and the patient. Social media (SM) has been recognized as a tool that could potentially help nourish and expand relationships in healthcare; however, much remains to be explored. OBJECTIVE A systematic literature Review (SLR) was conducted to explore the use of SM in the United States (US) healthcare setting, and the characteristics of its use, including barriers and facilitators. METHODS A SLR was conducted using three peer-reviewed databases; PubMed, MEDLINE and EMBASE. EBSCOhost database was included to gain a deeper understanding of companies’ use of SM and any lessons that can be learnt and applied to the healthcare setting. RESULTS Over the last decade there has been a rapid shift in the US towards the uptake of SM technologies, with many hospitals now using platforms such as Twitter and Facebook for communication, health promotion, education and research. SM can also present a competitive and financial advantage to increase a hospital’s reputation and reduce costs. However, despite its many proven or apparent uses, SM also brings with it many challenges, such as ethical considerations, need for clear guidelines and evaluation, perceptions and attitudes of patients and staff, and the possibility of mismatched offer versus patients’ needs. CONCLUSIONS The future of SM lies first of all in developing sound practices, and in its integration into the hospitals’ overall communication strategies, as well as expanding the number of uses and stakeholders involved.