BackgroundHome parenteral nutrition (HPN) can improve the nutritional status of patients with gastrointestinal dysfunction. However, some patients face a series of challenges during its implementation, which significantly affect their quality of life.AimsTo explore the experience and needs of living with home parenteral nutrition in adult patients.DesignA systematic review and meta‐synthesis.MethodsA search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Database and Wipu Database, to explore the real‐life experiences and needs of adult patients receiving HPN. The search covered the period up to March 2024. Qualitative research quality was evaluated using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research. Data synthesis was performed using Thomas and Harden's method of thematic and content analysis.ResultsTwelve studies, each offering qualitative data, were analysed, resulting in the identification of four themes: positive experiences of HPN; the interplay of dynamic changes across physical, mental and social levels; self‐adjustment to the new normal; and multidimensional needs of patients receiving HPN.ConclusionsPatients receiving HPN face multiple challenges physically, psychologically and socially. This paper also reveals the supportive needs of patients in adapting to a new lifestyle with HPN. This indicates that healthcare professionals should provide comprehensive, continuous and dynamic supportive medical services to facilitate patients' reintegration and return to normal social life.Patient and Public InvolvementAs this study constitutes a meta‐synthesis, patient or public contribution is not applicable.Reporting ApproachAdhering to the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) reporting guidelines, this meta‐synthesis was conducted.