The present article focuses on the meta-aggregative approach to qualitative evidence synthesis. Originally developed in Australia by the Joanna Briggs Institute, it mirrors the review process for reviews of effectiveness outlined by the international Cochrane and Campbell Collaboration, while remaining sensitive to the specific characteristics of qualitative research. Meta-aggregation is largely inspired by American pragmatism, hence its most distinct feature is that it produces synthesized statements in the form of 'lines of action' to be undertaken by practitioners and policy-makers. After a decade of implementing the meta-aggregative approach, we consider its challenges and outline how these can be dealt with in practice. We illustrate this by means of a worked example on experiences of pupils with special educational needs in inclusive education.