Emerging research shows adoptive and foster parents experience secondary trauma and compassion fatigue from direct or indirect exposure to their child's trauma and the emotional toll of caregiving. This review synthesizes qualitative literature on these experiences. Eleven studies were analyzed using a meta-ethnographic approach, revealing four themes: 1) parenting while navigating the complexities of trauma, 2) underestimating the challenges parents face, 3) challenges with the interplay of attachment, relationships and parental identity, 4) balancing compassion, sacrifice and heartbreak. Findings emphasize the need for better understanding and targeted support to improve outcomes for both parents and children.