Deaf people are known to have significantly poorer reading comprehension skills when compared to their hearing counterparts. This poses significant threats to text-based psychological assessments. The plethora of text-based self-report measures available provides ample opportunity to translate/adapt existing tools from text to sign language. This paper systematically reviewed the challenges and facilitators faced in previous translations/adaptations with the view to inform recommendations for future practice. This paper reports the results of a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-informed systematic review of 30 studies that had translated or discussed the translation of a written self-report measure into sign language following screening against inclusion/exclusion criteria. A systematic search (powered by EbscoHost Research Database and using search terms and Boolean operators), was performed in The Allied and Complementary Medicine Database (AMED), Cinahl, Medline, APA PsycInfo, and APA PsycArticles. The Quality Assessment with Diverse Studies tool was used for quality appraisal of the included papers. Challenges/facilitators to effective translation/adaptation were grouped under linguistic, procedural, and cultural. Examples of specific linguistic, procedural, cultural challenges, and facilitators are discussed in the context of previous research and study limitations. Translating/adapting text-based self-report measures to sign language is a linguistically and procedurally demanding endeavor that requires a deep bicultural/bilingual understanding of both deaf and hearing communities. The present results and recommendations can help researchers develop suitably accessible translated/adapted self-report psychological measures and this can have significant implications on healthcare service planning and delivery. (PsycInfo Database Record (c) 2021 APA, all rights reserved).