Background: Although preventable, occupational heat-related illness (HRI) is problematic in the United States. Farmworkers are disproportionately affected by HRI compared to other workers. Uncovering barriers that farmworkers face to the prevention of HRI is crucial to reducing HRI-associated morbidity and mortality. This integrative review aimed to understand U.S. farmworkers’ barriers to preventing HRI. Methods: An integrative review occurred following Whittemore and Knafl guidelines. Literature searches occurred on PubMed, Medline, and Agricola. After applying inclusion and exclusion criteria and removing duplicates, nine articles remained for review. Results: The reviewed articles revealed several themes related to prevention barriers: access, education and training, culture, and compensation. Conclusion/implications: This review indicates the need for more research to understand the barriers farmworkers face to HRI prevention. Providing prevention measures without considering obstacles to their use is ineffective in reducing HRI. Because many farmworkers lack oversight and regulation of prevention measures, focusing on barriers and areas over which farmworkers have more control could have a significant impact.