OBJECTIVES: Robust and explicit methods to conduct systematic reviews of economic evaluations are required to guarantee quality of reviews and their findings. This is especially needed when assessing high resource-consuming topics such as those related to the introduction of new imaging technologies. Our aim is to analyse the methods for systematic reviews of economic evaluations of health technologies. METHODS: We carried out a systematic review of methods for systematic reviews of economic evaluations by reading relevant parts of HTA methodological manuals (“manuals”) and HTA reports from UK (“reports”) in English and Italian at September 2010. RESULTS: We identified 27 manuals and 53 potential reports. Among them, 6 and 40 contained relevant information respectively. None of the 6 manuals described the criteria used for the identification or formulation of the methods, or gave guidance on which method to follow. Among the 40 reports included, 38/40 (95%) reports described search strategy and data bases used to identify studies and inclusion criteria were presented in 21/40 (53%) reports. The reports did not use a study quality assessment instrument were 9/40 (22.5%) while 20 different instruments were identified in the remaining reports. No report carried out a quantitative synthesis of the data from the systematic review and 9/40 reports (22.5%) clearly stated this. The reports that appear to include the data selectively in their economic evaluation were 13/40 (32.5%). CONCLUSIONS: The absence of clear methodological guidance in manuals is reflected in the reports. These show unclear rationale, methods and use of data from systematic reviews of economic evaluations.