Objective: To analyze the evidence available in the literature on harm reduction actions developed by primary healthcare. Method: Integrative literature review carried out in the databases MEDLINE, CINAHL, SCOPUS, Web of ScienceTM and LILACS. Results: Seventeen (17) primary studies published from 2008 to 2017 were included in this review. Care strategies for harm reduction included maintenance treatment with methadone, therapy with opioid agonists, needle and syringe distribution programs and the creation of rooms for supervised drug consumption. Health professionals were essential for consolidating inclusion strategies, possessing skills to listen without judgment and prejudice. Conclusion: Harm reduction care strategies have been disseminated in different countries and healthcare levels, aiming toward safe practice and quality, effective and risk-free care actions.