Hospital food services play a critical role in the management of all hospitalized patients. Optimal nutritional intake is considered crucial for both patient health and patient satisfaction with their hospital experience. Inadequate food intake throughout the course of admission may result in nutritional status deterioration, which is associated with prolonged length of stay, decreased quality of life, and increased morbidity and mortality. The prevalence of malnutrition in Canadian hospitals has been estimated to be as high as 45%, an issue which is the source of significant financial burden to health systems. In addition to the economic considerations, there is increasing focus on the importance of patient-centred and value-based health care within the Canadian system, approaches in which food service models may be central factors. Numerous strategies have been implemented to source, purchase, prepare, and deliver food within hospital settings both nationally and internationally, with no truly standardized approaches established. Some examples of these strategies include: restaurant style menus, on-demand dining, paper menus, meals served at a buffet service, communal dining halls, spoken menus or other electronic ordering systems, meal cart delivery service, cook-chill systems, high frequency meals, and traditional meal service models that typically consist of three meals per day served at the patient bedside. Understanding the differences between these service models and their possible benefits compared to each other is potentially valuable information for decision-makers who are responsible for the planning of food service models within their hospital facilities or jurisdictions. The purpose of the current report is to evaluate the clinical effectiveness, cost-effectiveness, and evidence-based guidelines regarding alternative room service food delivery models for hospital in-patients. The findings of this review are supplemented by a qualitative review of patient preferences and perspectives on the same topic, separately conducted by CADTH.