Aim To review the evidence regarding non‐transported older people who have fallen in relation to non‐transportation rates, outcomes and impact of alternate care pathways. Method Electronic databases were systematically searched until December 2011 as well as reference lists of included studies. Studies were eligible if they included data on non‐transportation rates, information on outcomes or alternate care pathways for older people who have fallen. Results Twelve studies were included. Non‐transportation rates following a fall ranged from 11% to 56%. Up to 49% of non‐transported people who have fallen had unplanned health‐care contact within 28 days of the initial incident. Attendance by specially trained paramedics and individualised multifactorial interventions significantly reduced adverse events including subsequent falls, emergency ambulance calls, emergency department attendance and hospital admission. Conclusion Limited but promising evidence exists to show appropriate interventions can improve the health outcomes of non‐transported older people who have fallen. Further studies are needed to explore alternative care pathways and promote more efficient use of our health services.