ABSTRACT Introduction This conceptual review is the first work to explore the concept of footwear needs. The review draws upon multidisciplinary literature to synthesise and formulate the first iteration of conceptual understanding of footwear needs. Methods A systematic search was performed and through a screening process, 81 studies were included in this conceptual review. The included studies were analysed using the pragmatic utility meta‐synthesis method to develop conceptual understanding and framework. The review process was further strengthened through expert consultation. Results The definition of footwear needs is defined as ‘footwear requirements for the well‐being of a person’. Preconditions of footwear needs include characteristics related to the person, product (footwear) and circumstances. Attributes of footwear needs encompass physical ( fit for foot and fit for purpose ), safety ( footwear safety and financial safety ), social ( fit for person and fit for society ) and emotional ( increase positive emotions and decrease negative emotions ) needs. Outcomes of footwear needs are related to physical, psychological and social aspects of a person. The conceptual framework of footwear needs illustrates the relationships between various factors underlying footwear needs. Footwear comfort is also identified as an allied concept and a potential outcome when footwear needs are achieved. Conclusion This conceptual review provides valuable insights into footwear needs, offering a foundation for future research and practical applications in footwear assessment, education and interventions.