Participation is a right and a key pillar of the active aging paradigm. This systematic review aimed to understand how older people's participation is conceptualized and to detail results regarding older people's perspective about their participation in the context of social and health care services. Twenty-one articles published between 1996 and 2015 were analyzed. The main findings suggested that diverse terminology is used to conceptualize older people's participation; however, all shared a vision of respecting a citizen's autonomy. Older people tend to have a paternalistic perspective although most seek more information and discussion on treatment options. Positive relations with providers enabled negotiation to address individual aspirations, though services tended to be pre-formatted suggesting low levels of adjustment to individual needs and aspirations. Thus, older people and those working with them need training in order to enable participation. In addition, services need to be more flexible to allow users to participate.