Objective: To determine the current evidence about patient and family engagement in communication with health professionals during transitions of care to, within and from acute care settings. Methods: An integrative review using seven international databases was conducted for 2003–2017. Forty eligible studies were analysed and synthesised using framework synthesis. Results: Four themes: 1) Partnering in care: patients and families should be partners in decision-making and care; 2) Augmenting communication during transitions: intrinsic and extrinsic factors supported transition communication between patients, families and health professionals; 3) Impeding information exchange: the difficulties faced by patients and families taking an active role in transition; and 4) Outcomes of communication during transitions: reported experiences for patients, families and health professionals. Conclusion: While attitudes towards engaging patients and family in transition communication in acute settings are generally positive, current practices are variable. Structural supports for practice are not always present. Practice implications: Organisational strategies to improve communication must incorporate an understanding of patient needs. A structured approach which considers timing, privacy, location and appropriateness for patients and families is needed. Communication training is required for patients, families and health professionals. Health professionals must respect a patient’s right to be informed by regularly communicating.