There has been growing research interest in what we term empathy-based stress, a process of traumatic stressor exposure, empathic experience, and adverse reactions among particular empathy-related professions, captured in the literatures on compassion fatigue, secondary traumatic stress, and vicarious traumatization in trauma-related lines of work. Although these three empathy-based strain constructs are highly related, each represents different components of similar strain responses. Unfortunately, extant reviews of the empathy-based stress literature are non-comprehensive and/or out of date. This qualitative review thus aims to synthesize and summarize the current literature on empathy-based stress at work and contribute to theoretical, methodological, and practical improvements in this area of research and practice. After introducing empathy-based strain constructs and their defining characteristics, we detail our review methodology and the primary theoretical and empirical themes derived through our review of the past decade of published literature. Then, we summarize conceptual, methodological, and analytical gaps in the empathy-based stress literature, helping to generate recommendations for the literature moving forward.