Objective To synthesize the psychological experiences of fear of falling (FOF) in older adults, so as to provide references for developing intervention strategies for healthcare professionals. Methods A systematic search was conducted across major domestic and international databases for qualitative studies exploring the psychological experiences of FOF in older adults, the retrieval period was from the database inception to November 2024. The Joanna Briggs Institute (JBI) 2020 Critical Appraisal Checklist for Qualitative Research was utilized to evaluate the methodological quality of the included studies, and findings were synthesized using a meta-aggregation approach. Results Totally 14 studies were included, yielding 46 findings, which were categorized into 12 themes and further grouped into 5 synthesized findings: risk perception, emotional responses, cognitive adjustments, behavioral modifications, and resource restructuring. Conclusion The causes of older adults′ FOF experiences are diverse, and they have different behavioral responses and needs towards fall prevention. Healthcare professionals and their families should pay attention to the psychological experiences of older adults′ FOF in time, and formulate corresponding prevention strategies accor-ding to the causes and consequences of older adults′ FOF and their coping needs, so as to improve the quality of life of the elderly.