Abstract: AIM To review the effects and safety of intravenous iron therapy in chronic heart failure with iron deficiency patients. METHODS Related randomized controlled clinical trials (RCTs) related to intravenous iron therapy in chronic heart failure with iron deficiency patients were collected and selected according to inclusion and exclusion criteria. The effects and safety of intravenous iron were compared with meta-analysis. RESULTS The present investigation included a total of five trials. The quality of the included studies was high. The grade of two studies was A, and three studies were evaluated as B. Meta analysis showed that intravenous iron therapy can improve serum ferritin ［SMD=2.15, 95%CI(0.84,3.45), P=0.001］, TSAT ［MD=7.97, 95%CI(5.71,10.23), P<0.01］ and NYHA ［MD=-0.56, 95%CI(-0.97, -0.15), P<0.01］, reduce the numbers of hospitalizations for heart failure［OR=0.27,95%CI(0.15, 0.47), P<0.01］, but can not reduce all-cause mortality ［OR=0.83, 95%CI(0.43,1.60), P>0.05］. Intravenous iron therapy did not increase gastrointestinal adverse events ［OR=1.11, 95%CI(0.36, 3.47), P>0.05］ or drug-related adverse events ［OR=0.81, 95%CI(0.26,2.46), P>0.05］. CONCLUSION Intravenous iron therapy in chronic heart failure with iron-deficient patients is both effective in improving symptoms of heart failure and safe, but does not significantly improve clinical prognosis.