The main objective of this research was to review the characteristics of portfolios and their outcomes for teaching professionalism to undergraduate medical students. A systematic review on the use of portfolios in teaching professionalism to medical students identified 1257 papers. Of these, 11 articles met all inclusion criteria. According to the papers, the use of portfolios for teaching professionalism shows versatility, supports learning strategies and has the potential to be used in different contexts, including for formative and summative purposes. The weaknesses were based on the artificiality of the reflections, deficient instructions, time-consuming processes and preference among students for other teaching methods. Students complained about feeling that the reflection was ‘forced’, and they tended to write based on social conventions rather than reveal their true thoughts. Reflection is a powerful component of the portfolio, but the method by which it is taught could easily ruin its potential to boost professionalism. Requiring reflection did not ensure its achievement; increased understanding by students regarding how and why they were doing it, the clarity of assessment methods and constructive feedback might strengthen the potential for success. A framework was designed to support faculty members in developing and applying portfolios with a clear and broad view of this teaching strategy.