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Objectives To understand experiences of stigma and discrimination among adults who are homeless across multiple care and support system contexts.Design Cross-sectional survey embedded within an ethnographic case study.Setting South London, UK, 2024.Participants Convenience sample of 74 people experiencing homelessness, aged over 18 years.Results Participants most commonly reported unfair treatment in public settings (85%), legal settings (72%), housing and homelessness services (68%) and health settings (65%). These experiences were attributed to a range of factors and identities, with homelessness the most commonly cited; people commonly linked unfair experiences to multiple identities. People with more comorbidities reported experiencing unfair treatment across more system settings, including and beyond health systems.Conclusions Unfair treatment was reported across multiple care and support systems with greater ill-health associated with more unfair treatment. Future larger-scale surveys should measure the extent of stigma and discrimination across the population.