We continue the conversation initiated by Sally Thorne’s observations about “metasynthetic madness.” We note that the variety of labels used to describe qualitative syntheses often reflect authors’ disciplines and geographical locations. The purpose of systematic literature searching is to redress authors’ lack of citation of relevant earlier work and to reassure policy makers that qualitative syntheses are systematic and transparent. There is clearly a need to develop other methods of searching to supplement electronic searches. If searches produce large numbers of articles, sampling strategies may be needed to choose which articles to synthesize. The quality of any synthesis is dependent on the quality of the primary articles; both primary research and qualitative synthesis need to move beyond description and toward theory and explanation. Synthesizers need to pay attention to those articles which do not seem to fit their emerging analysis if they are to avoid stifling new ideas.