Aim <p>This scoping review synthesizes international evidence on the health, medical, and nursing needs of people experiencing homelessness or housing instability, aiming to identify key care priorities and inform integrated support models.</p> Subject and methods <p>A systematic search was conducted in Medline and Springer databases, supplemented by gray literature and manual searches (Google, Google Scholar) between February and April 2025. Studies published in English or German from 2015 to 2025 focusing on the health situation of homeless and houseless individuals were included. Forty-nine studies were analyzed following PRISMA 2020 guidelines.</p> Results <p>The findings reveal a highly vulnerable population with pronounced multimorbidity and complex psychosocial burdens. Mental illnesses (77.5–98.8%), substance use disorders, and their frequent co-occurrence emerged as the most prevalent issues. Other major categories included unmet basic needs (nutrition, hygiene, housing), high exposure to violence and abuse (particularly among women), chronic somatic diseases (cardiovascular, respiratory, musculoskeletal), infectious diseases, reproductive health problems, and geriatric syndromes occurring at an earlier age. Many conditions are diagnosed late, often at advanced stages, due to personal, institutional, and structural barriers.</p> Conclusion <p>Addressing the health needs of homeless populations requires a paradigm shift toward integrated, intersectoral, and low-threshold health care models that combine medical, nursing, psychological, and social support. Early intervention, prevention, and outreach strategies are crucial, alongside trauma-informed approaches and adaptations of geriatric care for prematurely aged individuals. Sustainable improvement depends on long-term political commitment, adequate funding, and coordinated health and social policies to reduce health inequalities and improve quality of life for people experiencing homelessness.</p>