Following the first case of uncommon methodologies for conducting literature reviews, I describe in this case study a project that conducted a qualitative systematic review and concept analysis on tokenism in patient engagement to develop a preliminary set of dimensions of this concept. I discuss the various challenges encountered when designing, conceptualizing, and carrying out this study. For example, as there was limited literature on the topic of how patients and health care professionals conceptualized tokenism, I was required to find relevant data in studies with a primary objective that differed from the aim of the review: the determinants of patient engagement (aim of included studies) versus the various conceptualizations of tokenism (aim of the review). In some cases, participants used different terms to describe the degrees and levels of engagement, but in other cases, their discussion of determinants required a more interpretive juxtaposition between their experiences that may represent tokenism. Analytically, I also describe how challenging it was to retrieve data from primary studies that were not immediately relevant to the review’s research objectives. This required a considerable amount of iteration between the research objectives and data to ensure consistency and coherence. I also provide suggestions on how to justify restrictions on database search strategies, for example, limiting search to 10 years and certain countries. Finally, I highlight the limitations of analyzing participant perspectives and experiences captured in primary studies. As the perspectives and experiences are not fully accessible, reviewers have to be cognizant about the conclusions they make.