<p>Access to prescription medication is a critical component of healthcare; however, immigrant and refugee populations in Canada face barriers that contribute to inequities in access to these essential treatments, which may subsequently influence health outcomes. This scoping review examines the existing literature on prescription medication access among immigrant and refugee populations in Canada, identifying key barriers and addressing knowledge gaps affecting medication access and related health outcomes. The Joanna Briggs Institute scoping review methodology was employed, including 21 peer-reviewed studies and 6 grey literature reports. Using the Socio-Ecological Model of Health (SEM), the findings were synthesized across individual, interpersonal, organizational, community, and societal levels to examine factors influencing prescription medication access among immigrant and refugee populations. Barriers to prescription medication access were identified across multiple SEM levels. At the individual level, language barriers, cultural beliefs regarding medications, and limited health system literacy affected medication access. Interpersonal barriers included challenges in patient-provider communication and concerns regarding privacy. Organizational barriers included structural characteristics of the healthcare system, including the gatekeeper model and limited availability of interpreter services. Community-level barriers included socioeconomic constraints affecting the ability to obtain medications. Societal level barriers included variation in provincial prescription drug coverage, reliance on private insurance, and disruptions associated with the COVID-19 pandemic. Addressing inequities in prescription medication access among immigrant and refugee populations will require coordinated multi-level strategies that improve health system navigation, communication supports, and medication coverage.</p>