Unpaid caregivers across the UK face significant pressures, with those identifying as LGBTQ+ experiencing heightened and distinct challenges. The combined effects of the cost-of-living crisis and the COVID-19 pandemic have intensified concerns about the disproportionate burdens placed on unpaid caregivers. This article reports findings from an external evaluation of a NHS England and Improvement [NHSE/I] funded project examining the needs and barriers encountered by LGBTQ+ unpaid caregivers. Data were collected through interviews with three unpaid caregivers, two project leads, and 13 stakeholders. Thematic analysis revealed four interrelated themes; Recognition and Belonging; Social Connectivity and the Mitigation of Harm; Structural Inclusion and the Conditions for Culturally Safe Care; and Sustainability, Capacity Building and Transformative Co-production. A theoretically grounded framework of social harm was used for understanding LGBTQ+ unpaid caregivers experiences which demonstrated how structural inequalities compound the physical, financial and emotional pressures associated with caring. LGBTQ+ caregivers experienced a combination of interlocking harms produced not only by the demands of their caregiving role but also by their marginalised sexual and gender identities. This article has national relevance and international significance for understanding the experiences of LGBTQ+ unpaid caregivers to inform ongoing debates on effective and inclusive practice.