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Modern decision support systems (DSS) increasingly rely on heterogeneous data streams from IoT sensors, databases, text messages, and social media, represented in different formats and characterized by diverse semantic models and quality levels. The lack of semantically aligned integration results in inconsistent entity interpretation, duplication, and loss of context, which reduces the quality and timeliness of decisions. The aim of this paper is to systematize methods for semantic analysis and integration of heterogeneous information streams in DSS and to identify their benefits, limitations, and application domains. The study is conducted as an analytical review of publications from 2018–2025 focusing on semantic interoperability, ontologies and knowledge graphs, multi-source data fusion, data federation, and real-time stream processing. The review shows that semantic compatibility is primarily achieved through ontologies and knowledge graphs that define shared entities and identifiers and provide a flexible integration schema. For real-time decision-making, hybrid solutions combining a semantic layer with data fusion algorithms and source trust assessment are the most effective; published case studies report accuracy gains of about 15–20% and response-time reductions of up to 70–80% in multi-source settings. For unstructured streams, NLP and machine learning play a key role by extracting entities and relations and enabling semantic enrichment. The results can be used to design DSS for smart city, industrial, and healthcare domains. Furthermore, the paper highlights the role of standards like SHACL for validation and SPARQL for querying, enhancing the practical applicability of semantic approaches. Future directions include automating ontology alignment to reduce labor costs and integrating with AI for dynamic adaptation to new data sources.