BACKGROUND AND OBJECTIVES: A 'general practitioner with special interest (GPwSI)' refers to a GP who functions as a clinical intermediary between primary, secondary and tertiary care. This study aimed to advance understanding of the role, impact and potential of the GPwSI in Australia. METHOD: A systematic literature search was conducted. Studies that described the work of the GPwSI or examined how GPwSIs provide services to patients, including context, roles and outcomes, were included. Studies of all designs were analysed thematically using meta-synthesis. RESULTS: Fifty-nine articles were included. Studies showed significant diversity in settings, conditions and roles of GPwSIs; superior patient satisfaction and comparable outcomes to specialists, but a need for greater workforce regulation. DISCUSSION: This review shows the significant potential of both the role and impact of GPwSIs. It provides a warning regarding appropriate training, mentoring and ongoing professional development for GPs and employers adopting this role.