Supported decision-making is a process enabling people with cognitive impairment, including dementia, to participate in decision-making on matters affecting their lives. Evidence of how support is provided to people with cognitive impairment in acute-care settings is poorly understood. This study aims to identify and evaluate studies implementing supported decision-making strategies for people with dementia and related cognitive impairment in hospitals. Using Arksey and O’Malley’s five stage scoping review framework, we searched for terms related to “dementia”, “supported decision-making” and “hospital” within CINAHL, MEDLINE, Ovid, PubMed, SCOPUS, Web of Science, ProQuest Central and Google Scholar. We identified 7507 studies after de-duplication. Two independent reviewers screened titles and abstracts for eligibility based on population, concept and context. Subsequently, 109 full texts were screened with 25 studies included for review. Most studies (n=20) were exploratory (pre-implementation), reporting current practice, perceived enablers and barriers to supported decision-making use in the hospital setting. The perspectives of various health care professional disciplines, family carers and persons with dementia are included regarding decision-making for medical treatment, post discharge accommodation, goals of care and everyday decisions. Two studies evaluated a model for hospital based decision-making capacity assessment, and two further studies implemented support strategies using a video decision aid and enhanced consent procedure. Essential elements of supported decision-making implementation were knowing the person with dementia, a relationship of trust, balancing safeguarding with autonomy, communication strategies and organisational culture. Limited empirical evidence exists regarding effectiveness of implementing supported decision-making strategies within hospital contexts. Most studies are exploratory, reporting pre-requisites for support. Further studies addressing this knowledge gap are needed.