Aims: The purpose of this research is to help health-care professionals (HCPs) consider how hope is promoted and challenged during the rehabilitation of patients who have had a stroke or spinal cord injury (SCI). Background: Stroke and SCI are two chronic neurological conditions that require significant neurological rehabilitation. During the process of neurological rehabilitation, several internal, external or environmental factors can influence a patient's hope. While research has identified the importance of hope, it has not explicitly identified which factors influence patients' hope. Neither has existing research provided an evidence-based understanding of how health professionals can use strategies to help maintain patients' feelings of hope during rehabilitation. Methods: A qualitative narrative review was undertaken. Following a systematic search, 17 qualitative articles were identified that met the inclusion criteria. Thematic analysis was used to enable information to emerge regarding the strategies that promote hope and the factors that challenge hope. Results: The results included five hope-generating factors and four factors that challenged hope. Conclusions: This article identified several factors that influenced the hope of patients who have had a stroke or SCI. Hope is influenced by personal, social and situational factors, and many of these factors can have both positive and negative effects. Therefore, HCPs need to understand how to implement these ideas effectively. The current findings consider this.