Metasynthesis is an approach to synthesizing primary qualitative research, and may take either an aggregative or an interpretive approach. In either case, the resulting synthesis inevitably occurs at a remove from both the empirical and the theoretical contexts of the original research. We argue that seeking to retain these contexts in the synthesis poses specific challenges. Thus, the empirical context of an original study and the individuality of participants’ first-order accounts will be incompletely and selectively represented in a published study, and will be further out of reach at the level of synthesis. Syntheses should therefore be faithful to, but not seek to reproduce, the empirical context of the primary studies. As regards theoretical context, accommodating the concepts and the broader theoretical frameworks of primary studies may require potentially divergent philosophical assumptions to be reconciled with each other and with the theoretical standpoint of the synthesist. Selecting studies where these assumptions are compatible, at the level of both theory and methodology, may lessen this challenge. Some metasyntheses seek to integrate not just concepts but also theories (metatheorizing), but here the challenges of philosophical and theoretical compatibility are more acute, and the means of achieving such integration appear to be underdeveloped.