Purpose <p>To identify barriers and facilitators to the implementation of traditional Chinese exercises in cancer patients.</p> Methods <p>This was a mixed-methods systematic review. It searched for published studies from nine different sources. Data synthesis followed a convergent integrated approach according to the Joanna Briggs Institute methodology for mixed-methods systematic reviews. Quantitative data were qualitized using thematic analysis and synthesized with qualitative data using thematic synthesis.</p> Results <p>Twenty-one studies were included. Forty-three implementation determinants were identified across five domains of the Consolidated Framework for Implementation Research (CFIR), including 25 facilitators and 18 barriers. Key facilitators included perceived benefits, simplicity, social support, and flexible delivery, whereas major barriers involved symptom burden, resource constraints, competing life demands, and limited organizational support.</p> Conclusions <p>The implementation of traditional Chinese exercises in cancer patients is shaped by multilevel determinants across CFIR domains. Implementation outcomes depend on the alignment between intervention characteristics, patient capacity, and contextual conditions. Context-sensitive and tailored strategies are required to improve uptake and long-term sustainability.</p>