BACKGROUND:Health research through review of medical charts is a useful way to understand presentations related to the effects and burden of illness, disease and substance misuse. However, the design and methods used in studies can affect their validity and reliability. It is therefore vital to ensure a strong study design and to use appropriate methodologies. AIM:To highlight some of the challenges nurse researchers face when designing and conducting research using reviews of medical charts. DISCUSSION:This paper provides an approach for conducting research using retrospective reviews of charts and potential solutions to inherent challenges involved in such reviews. Using a systematic and scientific approach can maximise the benefits, minimise the limitations, and improve the rigour and impact of nursing research. CONCLUSION:This paper advances methodological discourse about the challenges inherent when using medical charts for data collection. Despite the inherent challenges, medical charts are an important source of information about injury, disease and substance misuse. IMPLICATIONS FOR PRACTICE:Nursing staff may face challenges when conducting research using patient medical charts. The quality of data abstracted from medical charts is affected by the data abstraction process used as well as the quality and accuracy of clinical documentation.