Background: Crisis support services play an important role in providing free, immediate access to support people in the community experiencing a personal crisis. Recently, services have expanded from telephone to digital modalities including online chat and text message services. This raises the question of what outcomes are being achieved for increasingly diverse service users across different modalities. Aims: This systematic review aimed to determine the expectations and outcomes of users of crisis support services across three modalities (telephone, online chat, and text message/SMS). Method: Online databases (CINAHL, MEDLINE, PsycARTICLES, PsycINFO, Psychological and Behavioural Sciences Collection) and gray literature were searched for studies measuring expectations and outcomes of crisis support services. Results: A total of 31 studies were included in the review, the majority of which were telephone-based. Similar expectations were found for telephone and online chat modalities, as well as consistently positive outcomes, measured by changes in emotional state, satisfaction, and referral plans. Limitations/Conclusion: There is a paucity of consistent outcome measures across and within modalities and limited research about users of text message/SMS services.