There are suboptimal levels of HPV vaccine uptake among gay, bisexual and men who have sex with men (GBMSM), despite the prevalence and incidence rates of HPV infection among GBMSM being higher than heterosexual males. This systematic review provides a thematic synthesis of qualitative research which examined the perceptions and experiences of GBMSM to HPV vaccine acceptability and explored the barriers and facilitators to participating in HPV vaccination. This review offers new insights about GBMSM understandings of HPV and how they are shaped by a complex relationship between limited knowledge and information of HPV, feminization of HPV with the focus on cervical cancer and women, and the socio-political governmentality of health services in meeting their health needs. Public health communication is required that focuses on the risks of HPV for anal, penile and oropharyngeal cancers and is culturally congruent to tailor and work with GBMSM more effectively for HPV vaccination. Healthcare providers need training around sexual health stigma and should proactively offer the HPV vaccination outside sexual health clinics for this vulnerable group.