OBJECTIVE: To identify whether mindfulness-based stress reduction is effective in improving physical health outcomes for long-term physical conditions. METHOD: A systematic review of the literature (retrieved from MEDLINE, PubMed and PsycINFO). RESULTS: Fifteen studies were included in the review. None of the studies assessed as having a low risk of bias demonstrated significant improvements in physical health status although there was some emerging evidence that mindfulness-based stress reduction may be useful in pain conditions. There was some preliminary evidence that it may also be effective in improving primary insomnia and irritable bowel syndrome. Small to moderate effect sizes were also found for asthma, pain, tinnitus, fibromyalgia and somatization disorders. CONCLUSION: Although there is some preliminary support for the use of mindfulness-based stress reduction in physical health conditions, further research is required before it could be considered an effective intervention for improving physical health outcomes.