Synthesising qualitative research involves working through difficult practical issues. Drawing upon our collective experience of undertaking three meta-ethnographies, we consider the forms of work – the practical action and practical reasoning – comprising this kind of synthesis and the difference they make to a meta-ethnography. We detail the origins and aims of meta-ethnography, and present a review of existing meta-ethnographies with a specific focus on the methods the authors reported as central to the conduct of meta-ethnography. We consider the implications of these methods and the reason for the presence (and absence) of particular practices in reporting on meta-ethnographies. Drawing upon our own experiences of conducting meta-ethnographies we focus on the methods used in two key practices central to meta-ethnography: ‘reading’ and ‘conceptual innovation’. We conclude by discussing how the meta-ethnographic process requires active reading, a recognition of multiplicity, a realistic approach to conceptual innovation and, importantly, collaborative work.