Spiritual needs often emerge in the context of receiving health or behavioral health services. Yet, despite the prevalence and salience of spiritual needs in service provision, clients often report their spiritual needs are inadequately addressed. In light of research suggesting that most social workers have received minimal training in identifying spiritual needs, this study uses a qualitative meta-synthesis (N = 11 studies) to identify and describe clients' perceptions of their spiritual needs in health care settings. The results revealed six interrelated themes: (1) meaning, purpose, and hope; (2) relationship with God; (3) spiritual practices; (4) religious obligations; (5) interpersonal connection; and (6) professional staff interactions. The implications of the findings are discussed as they intersect social work practice and education.