Purpose: This review mainly aims to identify the lean practice conducted in hospitals, determining what problems lean practice can be helpful to solve in the hospitals. Data sources: Four electronic databases (Scopus, Web of science, Medline, and PubMed) were conducted for searching related literature in this review. Study selection: These studies in the hospitals that related lean healthcare practice and contained outcome variables were included. Data extraction: Related information such as research design, countries, lean tools, outcome variables, results were extracted. Results of data synthesis: 20 eligible articles were identified in this review. There was 20% lean practice being conducted in emergency department of hospitals in this review. Six cases have implemented lean in Brazilian hospitals. There were 12 cases implemented lean practice through Value Stream Mapping. Conclusion: Lean practices were highly valued in Brazilian hospitals, and it was frequently implemented in hospital emergency department. Value Stream Mapping and process mapping were the most commonly used lean tool. Waiting time, lead time and Length of Hospital Stay (LOS) were the primary indicators reflecting improvements in this review.