<p>Patient-related violence is a serious, often taboo problem in the health system. It can be physical, psychological, or structural and affects people of all ages. The causes are, among others, power imbalances, staff shortages and lack of sensitization in the health system. The consequences range from trauma and therefore further burden for the health system to a loss of trust in the health system. Prevention strategies are therefore indispensable. This systematic review gives an overview of safeguarding and management strategies for patient-related violence in Europe. A systematic literature search in PubMed and Google Scholar up to June 2024 identified studies on safeguarding measures of patient-related violence in the European health system. Seven studies were analyzed according to type, setting, methods and results. A quality assessment by two independent reviewers ensured methodological validity and provided a comprehensive overview of the results. The studies show high levels of violence: In Germany, 33.3% of patients reported violence in psychiatric facilities and 4.5% of women reported sexual violence by medical staff. In Ireland, 64% of staff reported suspected cases. Those affected often feel inadequately protected. Prevention often fails due to a lack of knowledge, unclear responsibilities, and power imbalances. Better training, clear rules and participatory approaches are considered key steps towards better protection of patients. Patient-related violence and its prevention have been little researched to date. The studies analyzed emphasize structural weaknesses and a lack of awareness. The small number and heterogeneity of studies, as well as possible biases, limit the certainty of conclusions. Overall, more research and support in establishing safeguarding measures are needed to improve the prevention of patient-related violence and strengthen the health system.</p>