ObjectiveTo evaluate the efficacy and safety of Linggui Zhugantang in the treatment of heart failure. MethodCNKI，Wanfang Data，VIP，CBM，PubMed，ClinicalKey，Cochrane Library ，Web of Science ，Medline and Embase were systematically searched to screen randomized controlled trials（RCT）of Linggui Zhugantang in the treatment of heart failure. Meta-analysis was performed on the included studies using RevMan 5.3 ResultTwenty-seven studies were included with a total sample size of 3 569 cases，including 1 816 in experimental group and 1 753 in control group. Meta-analysis showed that compared with conventional drugs alone，combination of Linggui Zhugantang and conventional drugs improved the marked effective rate [relative risk（RR）=1.41，95% confidence interval（CI）[1.29，1.54]，P<0.000 01] and the total effective rate（RR=1.21，95%CI[1.17，1.25]，P<0.000 01），decreased the levels of serum B-type brain natriuretic peptide （BNP）[mean difference（MD）=-390.08，95%CI[-538.84，-241.52]，P<0.000 01] and serum N-terminal pro-brain natriuretic peptide（NT-proBNP）（MD=-713.83，95%CI[-828.41, -599.25]，P<0.000 01）， left ventricular end-diastolic diameter（LVDD）（MD=-5.23，95%CI[-7.18, -3.29]，P<0.000 01）, left ventricular end-systolic diameter（LVSD）（MD=-4.54，95%CI[-6.75，-2.33]，P<0.000 01）, tumor necrosis factor-α（TNF-α）（MD=-37.53，95%CI [-50.72，-24.34]，P<0.000 01）and interleukin-6（IL-6）（MD=-23.64，95%CI [-47.40，0.11]，P=0.05）, increased left ventricular ejection fraction（LVEF）（MD=5.73，95%CI [3.33，8.14]，P<0.000 01），and cardiac output [stroke volume (SV) ]（MD=5.90，95%CI[4.56，7.25]，P<0.000 01）. In addition, the combination prolonged the 6 minute walking test distance（MD=51.08，95%CI [33.01，69.16]，P<0.000 01），reduced the traditional Chinese medicine (TCM) syndrome score（MD=-3.50，95%CI [-4.92，-2.07]，P<0.000 01），and improved quality of life（MD=-7.26，95%CI [-10.43，-4.09]，P<0.000 01），with higher safety（RR=0.36，95%CI [0.17，0.79]，P=0.01）. ConclusionLinggui Zhugantang combined with conventional drug therapy could improve cardiac function，reduce cardiac fibrosis，and improve prognosis, with high safety.