A systematic review of 29 studies on the long-term mental health of war refugees found that mental disorders, including depression, PTSD, and anxiety, are highly prevalent among long-settled refugees. Prevalence rates ranged from 2.3% to 80% for depression, 4.4% to 86% for PTSD, and 20.3% to 88% for unspecified anxiety. These rates varied significantly based on the refugees' country of origin and the country they resettled in, with higher rates observed among refugees from former Yugoslavia, Cambodia, and the USA. Factors contributing to mental disorders included pre-migration traumatic experiences, post-migration stress, and poor socio-economic status. Higher methodological quality studies generally reported lower prevalence rates. The review highlighted the need for more consistent and rigorous research on the mental health of long-settled war refugees, as existing evidence suggests that mental disorders remain prevalent many years after resettlement. This increased risk may be influenced by both wartime trauma and post-migration socio-economic factors. The review also identified that factors such as gender, displacement duration, and interview language significantly influenced prevalence rates. Overall, the findings underscore the importance of addressing mental health needs in long-settled war refugees to improve their well-being.A systematic review of 29 studies on the long-term mental health of war refugees found that mental disorders, including depression, PTSD, and anxiety, are highly prevalent among long-settled refugees. Prevalence rates ranged from 2.3% to 80% for depression, 4.4% to 86% for PTSD, and 20.3% to 88% for unspecified anxiety. These rates varied significantly based on the refugees' country of origin and the country they resettled in, with higher rates observed among refugees from former Yugoslavia, Cambodia, and the USA. Factors contributing to mental disorders included pre-migration traumatic experiences, post-migration stress, and poor socio-economic status. Higher methodological quality studies generally reported lower prevalence rates. The review highlighted the need for more consistent and rigorous research on the mental health of long-settled war refugees, as existing evidence suggests that mental disorders remain prevalent many years after resettlement. This increased risk may be influenced by both wartime trauma and post-migration socio-economic factors. The review also identified that factors such as gender, displacement duration, and interview language significantly influenced prevalence rates. Overall, the findings underscore the importance of addressing mental health needs in long-settled war refugees to improve their well-being.