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Description: Individual decision-makers need communications that succinctly describe potential harms and benefits of different options, but policymakers or citizens evaluating a policy are rarely given a balanced and easily understood summary of the potential outcomes of their decision. We review current policy option communication across diverse domains such as taxes, health, climate change, and international trade, followed by reviews of guidance and evidence for communication effectiveness. Our conceptual synthesis identifies four characteristics of policy options that make their communication particularly difficult: heterogeneous impacts on different segments of the population, multiple outcomes, long timescales, and large uncertainties. For communicators that are trying to inform rather than persuade, these complexities reveal a core tension between issue coverage and comprehensibility. We find little empirical evidence for how to communicate policy options effectively. We identify promising current communications, analyze them based on the above synthesis, and suggest priorities for future research. Recognizing the particular challenges of balanced, effective policy option communications could lead to better guidelines and support for policy decision-making. https://www.nature.com/articles/s41599-018-0121-9