Abstract: Background　Current qualitative evidence on inadequate bowel preparation predominantly focuses on the overall colonoscopy experience, with limited exploration of patients' cognition, practices, and psychological adjustment during the homebased preparation phase. Moreover, findings from individual studies lack generalizability, highlighting the need for a targeted synthesis. Objective　To systematically review and synthesize qualitative studies on the bowel preparation experience prior to colonoscopy, identify key challenges, coping strategies, and support needs among patients during the preparation phase, and provide evidence to optimize patient education and nursing support. Methods　Qualitative studies on the experience of bowel preparation before colonoscopy were searched in PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang Data, and SinoMed (Chinese Biomedical Literature Database) from inception to March 2026. The Joanna Briggs Institute (JBI) Critical Appraisal Tool for Qualitative Research was used to assess the methodological quality of included studies. A meta-aggregation approach was employed to synthesize the findings, with particular attention paid to differences in study participants, national cultural backgrounds, healthcare contexts, and bowel preparation outcomes during the integration process. Results　A total of 17 studies were included. Fifty-eight findings were extracted and grouped into 12 categories, which were further synthesized into five integrated findings: physical and practical difficulties caused by bowel preparation, negative emotions occurring continuously before and after preparation, practical strategies used by patients to complete preparation, patients' needs for clear explanations and practical support, and re-evaluation of bowel preparation experiences after colonoscopy. Conclusion　Patients' experiences of bowel preparation before colonoscopy involve more than discomfort caused by taking laxatives. They constitute a continuous process involving physical reactions, information comprehension, home-based implementation, judgment of preparation adequacy, shame and self-blame after inadequate preparation, and post-procedural re-evaluation. Clinical nursing should avoid overly abstract education and provide more specific and feasible support focusing on whether patients can understand the instructions, carry them out, know how to manage discomfort, and remain willing to cooperate again after inadequate preparation.