OBJECTIVES: The analytic hierarchy process (AHP), a technique for multi-criteria decision analysis, is increasingly being used to support health care decision making. These decisions mainly relate to the application and coverage of health care technologies, and its use as a patient-reported outcome measure. The objective of this study is to review the use of this upcoming technique in health care; the Analytic Hierarchy Process. METHODS: We conducted a systematic review of the relevant medical, health-economical, psycho-sociological, managerial, and applied mathematical literature. We used the keywords “Analytic Hierarchy Process” AND (“patient” OR “patients” OR “health” OR “health care” OR “medical” OR “clinical” OR “hospital”) to search in the general topic of the articles within in the databases PubMed and Web of Science. RESULTS: We found 57 distinctive AHP applications in health care. Of the retrieved applications, 13 % focus on shared decision-making between patient and clinician, 25 % on the development of clinical practice guidelines, 5 % on the development of medical devices and pharmaceuticals, 44 % on management decisions in health care organizations, and 13 % on the development of national health care policy. CONCLUSIONS: From the review it is concluded that the AHP is frequently used and provides valuable support in complex health care decisions. The AHP is suitable to apply in case of complex health care decision problems, a need to improve decision making instead of explain decision outcomes, a need to share information among experts or between clinicians and patients, and in case of a limited availability of informed respondents. We also foresee the use of the AHP in conducting comprehensive Health Technology Assessments involving multiple stakeholders. Only for these specific types of decision problems, we recommend the use of the AHP.