Results: 78 articles were selected. most of the studies targeted health promotion/disease prevention (n = 35), followed by crisis communication (n = 24), general health (n = 13), and mis- information correction/health promotion (n = 6). engagement and message framing were the most analysed aspects. few studies focused on campaign effectiveness. only 18 studies had an experimental design. kmet evaluation was used to distinguish studies presenting a solid structure from lacking studies. in particular, considering the 0 � 75-point threshold, out of 74 studies, 28 were excluded (37 8% of the total). studies above this threshold were used to identify a series of aim-specific and medium-specific suggestions, as communication strategies employed differ quite greatly. conclusions: overall, findings suggest that no single strategy works best in the case of web-based healthcare communication. the extreme variability of outcomes and the lack of a unitary measure for assessing the end-points of a specific campaign or study leads us to reconsider the tools we use to evaluate the efficacy of web-based health communication. key messages: this systematic review provides an overview on web-based health communication. results suggest that no single strategy works best and the need to reassess its evaluation tools. communicating strategically is key for health organisations. this systematic review analyses a corpus of texts, in an effort to summarise and analyse existing, albeit fragmentary, evidence