The COVID-19 pandemic accelerated the uptake of virtual care, which is now routinely utilised in health care. Policymakers and healthcare funders have committed to integrating virtual care as a permanent component of service delivery. However, transitioning from in-person to virtual modalities alone is insufficient to ensure universal access and high-quality care. Realising the full potential of virtual delivery requires a renewed focus on embedding person-centred care (PCC) into the service. The PCC approach may improve patient satisfaction, reduce costs, and enhance system efficiency(1). Despite these benefits, guidance on how to operationalise PCC in virtual settings remains limited, particularly for middle-aged (45–64 years) and older adults (≥ 65 years), who may experience reduced benefits from virtual care due to digital, cognitive, and contextual barriers. Therefore, this mixed methods systematic review (MMSR) aimed to examine how PCC can be effectively delivered through virtual services for this population. The review followed the JBI MMSR guidelines, and a convergent integrated approach was undertaken to synthesise evidence from qualitative, quantitative, and mixed methods studies. The target population was adults aged ≥ 45 years; the phenomenon of interest was at least one PCC dimension as defined by the Australian Commission on Safety and Quality in Health Care(2); and the context was one-to-one virtual consultations delivered by healthcare professionals in community or hospital settings. Four databases (MEDLINE, CINAHL, Embase, and PsycINFO) were searched in May–June 2024, supplemented by reference lists and forward citation tracking. Eligible studies were peer-reviewed, full-text primary studies in English. No publication date limits were applied. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Mixed Methods Appraisal Tool(3). Quantitative data were qualitised and integrated with qualitative findings using thematic synthesis. Of 1,141 records, 43 studies met the inclusion criteria (13 mixed methods, 28 qualitative, and 2 quantitative descriptive), with 31 rated as high quality. Studies spanned primary, secondary, and community care settings, using mixed platforms (65%), telephone (19%), video (12%), or text/app-based modalities (5%). Six interrelated components of virtual PCC were identified: (1) relational rapport and trust—structured first encounters, continuity with familiar clinicians, and attention to relational cues; (2) shared decision-making and autonomy—collaborative goal-setting and balance between guidance and independence; (3) therapeutic communication and consultation structure—adapted pacing, signposting, and validation techniques; (4) digital access and literacy—device availability, technical support, and plain-language instructions; (5) telepresence and perceived connection—audio-visual quality, private space, minimising multitasking, and virtual etiquette; and (6) tailoring to readiness, preferences, and context—cognitive, cultural, and sensory accommodations. These components interact across individual, technological, and organisational levels, shaping patient engagement and perceived care quality, and offer actionable strategies for service design.