Objectives: To describe how mindfulness is delivered and to examine the effect of mindfulness on health-related quality of life (HRQOL), mindful awareness and stress in adults with a respiratory diagnosis. Method: Five electronic databases were searched. Data were extracted and assessed for quality by two reviewers. Results: Data were extracted from four studies. Interventions were based on Mindfulness-Based Stress Reduction and delivered by trained instructors. Recordings of mindfulness were provided for home-based practice. One study targeted the intervention exclusively to anxious individuals with a respiratory diagnosis. Adherence to mindfulness was poor. No effects were seen on disease-specific HRQOL (Standardized mean difference (SMD) = -0.21 95% CI: -0.36 to 0.48, p=0.78), mindful awareness (SMD = 0.09 95% CI: -0.34 to 0.52, p=0.68) or stress levels (SMD = -0.11 95% CI: -0.46 to 0.23, p=0.51). Conclusion: Mindfulness interventions, delivered to individuals with a respiratory diagnosis, varied widely in terms of delivery and the outcomes assessed making it difficult to draw any conclusions regarding its effectiveness. Practical implications: Future mindfulness interventions for those with a respiratory diagnosis should be standardized for intervention, duration and outcome measures. Interventions should target specific sub-populations who have anxious symptoms and offer active long-term follow-up.