Trauma-informed care recognises the negative impact of past trauma on mental health, integrates trauma knowledge into mental health practice and aims to prevent re-traumatisation. However, despite the benefits of trauma-informed care, its implementation in acute psychiatric inpatient settings is challenging. This literature review found three main barriers to the implementation of trauma-informed care in adult inpatient psychiatric settings – vicarious trauma, organisational barriers and coercive practices. Vicarious trauma from repeated exposure to patient distress negatively affects staff resilience; organisational barriers, including inadequate leadership, lack of resources and inadequate staff training, compromise staff well-being and the capacity of staff to deliver trauma-informed care; and coercive practices such as restraint and seclusion conflict with the principles of trauma-informed care. Addressing these barriers is crucial and future research should focus on strategies for overcoming them.