Purpose – The purpose of this paper is to present a conceptual framework that categorises the features and characteristics of the built environment that impact on health outcomes. Design/methodology/approach – An extensive literature review was carried out. A total of 1,163 abstracts were assessed, leading to 92 papers being reviewed. Findings – There is a considerable amount of evidence linking healthcare environments to patients’ health outcomes, despite the lack of clarity in relation to cause-effect relationships. Originality/value – The paper proposes a theoretical framework linking different built environment characteristics to health outcomes. This framework provides a structure to group causal effects according to their relation with design features, materials and ambient properties, art and aesthetic aspects and use of the built environment. Keywords Environmental health and safety, Environmental psychology, Facilities, Design Paper type Conceptual paper