To systematically review the efficacy and safety of Shenfu Injection combined with the basal therapy for acute heart failure.Methods:Databases including CNKI，WanFang Data，VIP，Chinese Biomedical Literature Database，Embase，PubMed，Web of science and Cochrance Library were electronically searched from inception to June 2019 to collect randomized controlled trials on Shenfu Injection in the treatment of acute heart failure.A total of 2 researchers independently screened literature，extracted data，and assessed risk of bias of included studies.Then，Meta-analysis was performed on the the clinical effective rate，BNP，NT-proBNP，LVEF and incidence of adverse reactions，etc．via RevMan 5.3 software.Results:A total of 22 RCTs involving 1 753 patients were included.The results of meta-analysis showed that:compared with control group，the Shenfu Injection combined with the routine therapy could improve the clinical effective rate，BNP level，NT-proBNP level，LVEF，LVFS and traditional Chinese medicine(TCM)syndrome score.However，there were no significant differences between 2 groups in rate of adverse reaction.Conclusion:Shenfu Injection combined with the Western mediicne can improve the clinical efficiency，reduce BNP，NT-proBNP levels，improve cardiac function(LVEF，LVFS)with good safety.Due to limited quality and quantity of the included studies，more studies are required to verify the conclusions above.