Objective：To systematically review the efficacy and safety of tolvaptan for the patients with heart failure. Methods：Databases of PubMed，Embase，Web of Science，The Cochrane Library，CBM，CNKI，VIP and WanFang Data were electronically searched for rel－evant studies from inception to October 2013. Two reviewers independently screened literature，extracted data，and assessed the meth-odological quality of the included studies according to the inclusion and exclusion criteria as well as the methods recommended by the Cochrane Collaboration. Then，Meta-analysis was performed using RevMan 5.2.3 software. Results：Eight trials involving 4 908 patients were included. The results of Meta-analysis showed that tolvaptan was more effective than placebo in increasing the serum sodium concentration（MD=3.63，95%CI=3.32 to 3.94，P=0.000），and in decreasing body weight（MD=-0.81，95%CI=-0.92 to -0.70，P=0.000）. In addition，the incidence of adverse events was significantly lower in the placebo group（OR=0.27，95%CI=0.20 to 0.38，P=0.000）. Conclusion：Tolvaptan is effective for patients with heart failure and hyponatremia and patients can tolerate the adverse events well.