Abstract Aims: The aim of this study was to synthesize the evidence on the effects of SGLT2i on multiple outcomes in the treatment of heart failure and to analyze the effects of different SGLT2i and heart failure on outcomes. Methods: We searched Pubmed, MEDLINE, Embase, and Web of Science. Randomized placebo-controlled parallel trials evaluating the efficacy of SGLT2i on the treatment of heart failure and reporting one of all-cause death, cardiovascular outcome, health status, cardiac function, laboratory indicators, and the safe outcomes were included, whose follow-up time were more than one month. Results: Our meta-analysis demonstrated that SGLT2i reduced the risk of cardiovascular mortality and hospitalization for heart failure. Also, SGLT2i increased KCCS-CSS and KCCS-TSS score. Furthermore, SGLT2i reduced patients’ LVEDVI, body weight and systolic blood pressure. Additionally, SGLT2i protected against the risk of severe adverse events, acute kidney injury, but was more likely to cause hypotension, urinary tract infection and genital infection. Unfortunately, SGLT2i raised creatinine levels in patients. We could observe similar trends in results from outcomes where subgroup analysis by different SGLT2i and heart failure. Conclusion: SGLT2i contributed to better cardiovascular and survival outcomes. SGLT2i also improved health status, heart function and metabolism to some extent. In addition, SGLT2i was generally safe, but with higher risk of urinary tract infections, genital infections, hypotension and creatinine levels. Keywords: SGLT2i • Heart failure • Cardiovascular outcomes • Health status • Cardiac function