Abstract Background In Europe, the prevalence and costs of dementia, including Alzheimer’s disease, are rising due to demographic changes. The care provided does not adequately address the needs of stakeholders involved. This systematic review aims to identify the needs, and unmet needs in European dementia care, thus providing a comprehensive framework to improve dementia care services. Methods Our inclusion criteria, adhering to PRISMA guidelines, include studies published from 2013 to 2023, and addressing needs and unmet needs of persons living with dementia, caregivers, and dementia care professionals. Risk of bias was evaluated using the Mixed Methods Appraisal Tool. Results From an initial pool of 3738 articles, 48 studies meet inclusion criteria. Caregivers express need for support, notably in psychological and logistical assistance, in managing daily errands and healthcare tasks, and to navigate healthcare system, exacerbated by the stress and isolation during the COVID-19 pandemic. Persons living with dementia face challenges in social inclusion due to the lack of public understanding and community-based care. Dementia care professionals emphasise need for more training and resources to manage dementia effectively, with a recent shift towards the necessity for telehealth competencies. Furthermore, caregivers from ethnic minorities highlight the importance of culturally sensitive healthcare access to overcome cultural and language barriers. Conclusions Educational resources, broaden community support, clear information about available care services, and public understanding of dementia were the most commonly expressed unmet needs. Addressing these needs within the dementia care network is crucial for better service integration and improving the quality of life for all stakeholders involved. Future research should focus on developing strategies to address the unmet needs, ensuring robust support for the increasing number of individuals affected by dementia. Key messages • Care dementia effectively needs more resources, training, and a culturally sensitive healthcare access to ethnic minorities. • People living with dementia and caregivers need psychological and community-based support, social inclusion, clear information about available care services, and public understanding of dementia.