Background: Health system transformation refers to comprehensive changes aimed at improving the efficiency, quality, equity, and sustainability of healthcare delivery. This transformation can be driven by various factors and often encompasses technological advancements, policy and regulatory changes, economic aspects, innovation in service delivery, and global health challenges. Objectives and Methods: This narrative review aims to comprehend different health system transformation models, drivers of change, and associated outcomes. Its scope focuses on European countries and their diverse population profiles, health status, and environmental, economic, and political contexts. The review covers the building blocks of health systems (governance, service delivery, workforce, information systems, medical products, vaccines, technologies, and financing). It particularly looks at initiatives integrating bottom-up and top-down approaches to system changes. Results: Inspired by the recent policy brief of the European Observatory on Health Systems and Policies titled "Transforming Health Service Delivery: What Can Policy-Makers Do to Drive Change?", this review provides a summary of the evidence, identifying common themes, trends, gaps, and divergences in the literature. The intended changes in the health system models of various European countries often aim to address current challenges, improve efficiency, enhance patient outcomes, and ensure sustainability. The theoretical and practical approaches to health system transformations often fail to emphasize practical steps for achieving higher quality and efficiency of health service delivery, which would be more responsive to demands. Nevertheless, the main themes in the transformation of health systems underline the consumer-centric approach with acknowledgement of human rights and vulnerable groups, universal health coverage, and application of innovative and affordable technologies with "more resources in the right places". Actual literature underlines coordination across primary, secondary, and tertiary care to provide comprehensive services that address the full spectrum of patient needs while also respecting a community-based approach by leveraging health workers and local resources to deliver care, particularly in underserved areas. Conclusions: In an era of rapid technological advancements and shifting demographics, transforming health systems has become critical. Integrating digital health solutions, promoting preventive care, and addressing social determinants of health are essential for long-term success in times of change.