Loneliness is a significant social and public health issue, particularly among gay men who often face unique challenges shaped by their social identities and minority status. These challenges often exacerbate feelings of isolation and exclusion, yet the specific ways in which gay men experience loneliness remain underexplored. This study aimed to offer insights for health professionals and policymakers via a systematic review and meta-synthesis. A comprehensive literature search was conducted in May 2024 across five major databases and gray literature to identify appropriate qualitative studies (i.e. if they focused on the experiences of loneliness among gay men, were qualitatively designed, and included participants over the age of 18). 72 studies, encompassing approximately 1335 participants were analyzed. Guided by Intersectionality Theory and the Minority Stress Model, data analysis generated three categories that impacted gay men's experiences of loneliness. (1) external influences of discrimination (lack of support systems, cultural standards, geographic location), (2) internal conflicts (internalized homophobia, concealment, fear of rejection), and (3) coping mechanisms (sex, substance use, social life and connections, embracing solitude). The findings highlight the complex interplay between external pressures and internal struggles, as well as how intersecting identities shape the diverse experience of loneliness among gay men.