Objective: Systematic review of the efficacy and safety of neoactivin re-acute myocardial infarction with heart failure. Methods: The computer retrieved CNKI, Wan Fang, Weipu Chinese Science and Technology Periodicals Database (VIP), China Biomedical Literature Database (CBM), Medline, Cochrane Library, and Clinical Trail. Gov collected clinical randomized controlled trials (RCTs) of neoactivin in the treatment of acute myocardial infarction with heart failure from the establishment of the database to December 2019. Data were extracted according to the Jadad scale, disease inclusion and exclusion criteria, and RevMan 5.3 software was used for Meta analysis. Results: A total of 23 RCTs were included, with a total of 2024 patients, including 1012 patients in the control group (conventional treatment with western medicine) and 1012 patients in the test group (on the basis of the control group + neoactivin treatment). Meta analysis results show that: in the total effective rate, the test group was better than the control group, and the difference was statistically significant (OR = 4.30, 95％ CI [3.26, 5.67], P <0.00001); In terms of left ventricular ejection fraction, the test group was better than the control group, and the difference was statistically significant (OR = 1.58, 95％ CI [1.27, 1.90], P <0.00001). In terms of the left ventricular end-diastolic diameter, the test group was better than the control group, with a statistical difference Significance (OR =-0.91, 95％ CI [-1.50, -0.33], P = 0.002);In terms of stroke volume, the test group was better than the control group, and the difference was statistically significant (OR = 1.24, 95％ CI [ 0.55, 1.94], P = 0.0005); In terms of brain natriuretic peptide precursors, the experimental group was better than the control group, the difference was statistically significant (OR =-4.37, 95％ CI [-6.21, -3.25], P <0.00001 ); In terms of heart rate, the test group was better than the control group, and the difference was statistically significant (OR =-13.70, 95％ CI [-14.95, -12.46], P <0.00001); In terms of systolic blood pressure, the test group was better than the control Group, the difference was statistically significant (OR =-12.38, 95％ CI [-17.98, -6.79], P <0.00001); In diastolic blood pressure, the test group was better than the control group Group, the difference was statistically significant (OR =-7.42, 95％ CI [-8.53, -6.30], P <0.00001); In terms of adverse reactions, the difference was not statistically significant (OR = 0.95, 95％ CI [0.29, 3.16], P = 0.94). Conclusions: In patients with acute myocardial infarction and heart failure, the timely application of neoactivin treatment can improve clinical efficacy, improve cardiac function, inhibit ventricular remodeling, improve blood pressure and heart rate, which has good clinical efficacy and safety.