Unidentified patients pose unique challenges in emergency and trauma care, where rapid registration and treatment initiation are essential despite the absence of formal identification. Naming these patients is critical for safe clinical care, communication, and legal documentation. This narrative review synthesizes the literature on who unidentified patients are, the issues associated with naming them, and the naming systems currently used. Studies consistently describe these patients as predominantly young males presenting with trauma, substance misuse, or altered consciousness, often from socially vulnerable groups. While naming enables care delivery, existing practices-including generic placeholders like John/Jane Doe and various structured systems such as NATO phonetic codes or randomized aliases-carry risks of duplication, operational confusion, and misidentification, potentially leading to treatment errors and delays. Policy recommendations advocate for unique, randomized naming systems, yet there remains a lack of comparative evaluation and standardization across settings. Future research should focus on assessing the safety and usability of different naming systems and developing internationally harmonized frameworks to enhance patient safety and dignity in routine and mass casualty contexts.