Texture modification is the primary therapeutic strategy for managing oropharyngeal dysphagia (1), a swallowing disorder that can lead to aspiration, pneumonia, reduced dietary intake, and malnutrition (2). Dysphagia affects over one million Australians and up to 75% of aged care residents (3). However, current standard texture modified foods (TMFs) are often nutritionally inadequate, bland, visually unappealing, and lack variety, potentially reducing food intake, mealtime satisfaction, and quality of life (4). This systematic review sought to answer the question: What is the impact of current standard TMFs on the health outcomes and quality of life of aged care residents with dysphagia? The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) 2020 guidelines (5). A systematic search of Scopus, MEDLINE, Web of Science, and CINAHL identified 1,927 studies. The review question, search strategy, and eligibility criteria were developed using the PICO framework (Population, Intervention/Exposure, Comparison, and Outcome). Title, abstract and full-text screening were conducted in Covidence by two independent reviewers. Following screening, 35 studies were included. Due to substantial heterogeneity in study designs, interventions, and outcome measures, a meta-analysis was not feasible and findings were synthesised narratively. Studies were grouped into three analytical categories: 1. regular food versus standard TMFs, examining nutritional composition and health outcomes; 2. standard versus enhanced TMFs, evaluating the effects of improvements in composition, preparation, presentation, and delivery; and 3. quality of life and lived experiences, exploring residents' experiences and mealtime satisfaction. Compared with regular diets, standard TMFs were associated with lower energy intake (250 - 450 kcal/day), lower protein intake (6 - 8 g/day), lower fibre intake (3.9 - 4.6 g/day), inadequate intake of 9 of 20 micronutrients, and a 31% higher risk of malnutrition. Studies examining quality of life and mealtime experiences consistently indicated that, in addition to nutritional inadequacy, standard TMFs were associated with reduced dietary variety, diminished dignity, and poorer meal experiences. Improvements in flavour (90%), presentation (63%), and aroma (57%) increased acceptance and satisfaction, highlighting the importance of sensory qualities in shaping mealtime experiences and preserving dignity. Studies evaluating enhanced TMFs (nutritionally fortified, reshaped/molded) reported improved nutritional outcomes, increasing energy intake by approximately 150 - 200 kcal/day (up to 611 kcal/day), protein intake by 4 -14 g/day (up to 18.3 g/day), body weight by 0.4 - 3.9 kg, body mass index by 1.0 - 1.5 kg/m², and Mini Nutritional Assessment-Short Form scores by approximately 2 points. Current evidence suggests that poorer outcomes are associated with the nutritional quality, preparation, and presentation of TMFs rather than texture modification alone. Improving nutritional value, flavour, appearance, and variety may enhance dietary intake, mealtime satisfaction, quality of life, and overall wellbeing among aged care residents with dysphagia.