Objective To analyze and clarify the concept of narrative foreclosure in older adults with chronic conditions. Methods A systematic search was conducted in databases including Web of Science, PubMed, ProQuest, Scopus, CINAHL, SinoMed, CNKI, VIP, and Wanfang from inception until September 2025. Literature on narrative foreclosure in older adults with chronic conditions was screened according to the inclusion criteria. Rodgers′ evolutionary concept analysis method was used to analyze the literature. Results A total of 23 articles were included. Narrative foreclosure in older adults with chronic conditions comprises three defining attributes: morbid consolidation of identity, fragmentation of the time dimension, and loss of narrative agency. Its antecedents include physical, psychological, interpersonal, and socio-environmental factors. Consequences encompass hindering disease self-management, exacerbating negative emotions, and eroding meaning in life. Conclusion Through concept analysis, this study clarifies the defining attributes, antecedents, and consequences of narrative foreclosure in older adults with chronic conditions. Future research and nursing practice can be developed based on this conceptual clarification.