ABSTRACT Background Understanding how music group facilitators work across the health-care continuum has received sparse research attention. Methods An explanatory multiple case study design was used to identify approaches employed by experienced facilitators. Five music facilitators working in contrasting areas of practice were interviewed and video recorded engaging with the same groups at three timepoints. Results All facilitators demonstrated four common behaviours: applying a consistent structure for each session; creating a positive and relaxing atmosphere for the work; engaging with varying musical repertoire and activities; and offering clear instructions for the participants. Their styles of practice were found to be shaped by their personality, educational background, as well as the size of the group, health conditions, and cultural identities of their music participants. Conclusion These skilled facilitators showed flexibility, always aiming to accommodate participants’ needs, and revealing new evidence of a common approach to music facilitation across different types of participant groups.