Objective: The aim of this study was to assess the impact of anemia on the clinical outcomes of chronic heart failure (CHF) by a meta-analysis and systemic review of published literatures.Methods: Twenty published English language articles were selected from Medline, PubMed and ISI Database. Clinical data were extracted, pooled and analyzed with a fixed or random effects model.Results: A total of 97,699 patients with CHF were identified from the published studies. Meta-analysis of these studies indicated that anemia is associated with a higher risk for death (relative risk or RR, 1.66, P<0.0001). In addition, anemic patients had more advanced NYHA class (NYHA III-IV, RR, 1.35, P<0.0001) and lower left ventricular ejection fraction (weight mean difference or WMD, -0.53, P<0.0001) than in non-anemic patients. Systemic review also revealed that the severity of anemia is closely related to the rate of mortality and hospitalization for heart failure.Conclusions: Anemia is associated with an increased risk of mortality and rate of hospitalization for heart failure. Anemia is an independent risk factor for adverse outcomes in patients with CHF.