Background: The global population of older refugees is growing, yet their unique ageing experiences and functional health needs remain insufficiently understood. This scoping review maps current evidence on functional changes among older refugees (≥60 years) living in host communities—a group at high risk of accelerated decline due to trauma, displacement, and resettlement stressors. Method: A scoping review was conducted using Joanna Briggs Institute (JBI) methodology. Five databases (CINAHL, Scopus, Ovid MEDLINE, PsycINFO, and ProQuest Central) were searched for English-language, peer-reviewed studies published from 2015 to 2025. Of 2,436 identified records, 28 studies met the inclusion criteria. Results: Older refugees experience substantial physical, mental, and cognitive challenges—including non-communicable diseases, depression, PTSD, and memory difficulties—that collectively impair functional ability. Declines in activities of daily living (ADLs), mobility, and social participation were linked to social determinants such as low education, financial hardship, and limited English proficiency. Pre-migration trauma and post-migration barriers, including stigma, discrimination, and fragmented support systems, further undermined functional health. In contrast, family networks, ethnic communities, and culturally responsive services enhanced resilience and engagement. Older refugees frequently reframe or underreport health concerns due to cultural perceptions and stigma, delaying help-seeking and worsening functional decline. Conclusion: Older refugees face heightened functional impairment driven by the intersecting effects of trauma, ageing, and systemic barriers. Community-based, co-designed interventions are needed to improve early detection and support. Policymakers and practitioners must prioritise integrated, culturally responsive strategies that address clinical and social determinants to promote equity and healthy ageing in this vulnerable population.