Patient engagement has been recognized as a National Patient Safety Goal, and patients play a key role in ensuring safety in health care. This systematic review discusses 31 different patient-reported safety climate measures addressing items such as patient-centered care, health care costs, and comfort. The authors note that few measures report satisfactory validity and reliability, and few measures have had systematic usability testing. They suggest that future research focus on developing a stand-alone measure with high validity and reliability, and assess core safety climate domains from a patient perspective with an emphasis in primary care.