Registered dietitians assess, diagnose and treat nutritional problems. Although integral to healthcare, their role in spiritual care is unknown.We conducted a systematic review of spiritual needs and spiritual care in nutrition and dietetic practice.Subject headings and keywords were used to search Medline, CINAHL, PsycINFO, AMED for studies exploring spiritual care and nutrition or dietetic practice.From 1433 records, 13 studies were included. Medium quality evidence showed unmet spiritual needs among dietetic patients suffering from cancer, COPD, heart failure and diabetes. Unmet needs occurred in patients from a variety of ethnicities, religions and none. However, dietitians were only involved in spiritual care regarding nutrition and hydration at the end of life.Integrating spiritual screening and sign-posting within dietetic practice is prudent, but clinical trials are needed to evaluate its effectiveness.