Objective To systematically review the efficacy of Chinese medicine injection (CMI) for treating heart failure (HF).Methods CNKI, WanFang Data, VIP, The Cochrane Library, PubMed and EMbase databases were electronically searched from inception to January 2021 to identify randomized controlled trials (RCTs) on CMI for treating HF. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Network meta-analysis was then performed by RevMan 5.2 software and Stata 16.0 software.Results A total of 47 studies were included, involving 4 902 patients and five types of CMIs, including Shenmai, Shenfu, Yiqi Fumai (lyophilized), Shengmai and Danhong injections. The results of network meta-analysis showed that the efficacy of combined CMIs was superior to conventional Western medicine alone. For the main efficacy, Shenmai, Shengmai and Shenfu injections had significant advantages in improving the total clinical effectiveness. Shengmai, Shenmai and Yiqi Fumai (lyophilized) injections were significantly better for reducing NT pro-BNP levels than the other injections. Shenfu and Shengmai injections were significantly better for reducing BNP levels than the other injections. Shenmai, Danhong and Shengmai injections were significantly better for improving the left ventricular ejection fraction than the other; injections. These CMIs showed similar advantages for secondary efficacy indicators as for main efficacy indicators.Conclusions Combined five types of CMIs for treating HF can improve the clinical efficacy when compared with conventional Western medicine treatment. Shenmai injection, Yiqi Fumai injection (lyophilized) and Shengmai injection, which is part of Sheng Mai San, have clear advantages in terms of the overall curative effect or on individual indices.