Introduction: Occupational therapists have long‐held a role in prescription and recommendation of pressure support. Although different alternating and static pressure mattresses are available, there is a lack of independent evaluation of the relative effectiveness of these mattresses. Objectives: To summarise the evidence regarding the effectiveness of different types of pressure mattresses and overlays and provide guidance for prescription by occupational therapists. Method: A systematic search was conducted by searching online databases for relevant systematic reviews and randomised‐controlled trials (RCTs) published since 2000. A grey literature search was also conducted to identify further articles. The quality of each RCT was assessed using the PEDro scale. Results: A total of 46 studies were included in the review, including 6 systematic reviews. Quality of RCTs varied (4 to 9/11 on PEDro scale), however were predominantly of low to moderate quality. Studies were often under‐powered with methodological flaws. Studies were most frequently conducted in acute or residential care facilities, with no RCTs completed in a community setting. The literature supported the use of pressure‐relieving mattresses in the prevention and healing of pressure injuries. Research was inconclusive regarding the relative effectiveness of the support surfaces, with some studies finding no significant difference and others with conflicting conclusions. Conclusion: The available evidence is inconclusive regarding the relative effectiveness of static versus alternating pressure mattresses. Further research is required to investigate what type of mattress provides the best outcomes for clients in a community setting.