1. The poultry sector is possibly the fastest growing and most flexible of all livestock sectors. At present, the main changes to the table egg production system include the gradual abandonment and closure of all cage-housing systems for laying hens, driven by animal welfare concerns and stricter legislation in many countries. In the future, keeping hens in enriched cage systems may be restricted or phased out in response to evolving animal welfare guidelines and public demand. To meet the welfare and behavioural requirements of the hens, it is desirable to choose housing on litter or housing in aviaries as a substitute for housing in enriched cages. 2. The objective of this systematic review was to examine non-cage housing systems and hemp-based dietary interventions in relation to skeletal health in laying hens. This review focussed on the risks associated with alternative housing systems, particularly the increased incidence of bone fractures and the potential of nutritional strategies to mitigate skeletal disorders, including osteoporosis.3. The proportion of hens housed in non-cage alternative housing systems is currently increasing sharply but carries certain risks. One of the most significant concerns is skeletal integrity, as hens in aviaries experience a higher rate of keel bone fractures due to collisions, falls and deviations thought to be related to internal pressure. Numerous studies have shown that the incidence of keel bone damage (i.e. fractures and deviations) was greater in aviaries compared to enriched cage systems. 4. Optimal skeletal health can be supported through proper nutrition, which plays a crucial role in bone metabolism. Key nutritional elements, including calcium, vitamins D, E and K, polyunsaturated fatty acids and hemp-based products, have been shown to be beneficial in preventing skeletal disorders and associated fractures due to their specific roles in maintaining bone structure and strength.