OBJECTIVES: Randomized trials have shown that blockade of beta adrenergic receptors leads to symptomatic improvement, reduced hospitalization and enhanced survival in many patients with heart failure (HF) and reduced ejection fraction. The objective of this study was to compare beta blockers for their efficacy in reducing mortality. METHODS: A systematic literature search for randomized clinical trials for use of beta blockers in HF was undertaken for the databases Pubmed, Embase, Biosis, Google Scholar and Cochrane. Data was collected for the study type, methods, country and key findings. Extracted study data included study design, patient charatcertristcis and primary outcomes. A bayesian random effects network meta-analysis (NMA) model was developed in WinBUGS14. RESULTS: We identified 830 references and found 21 randomized trials in 23,122 patients with 3,871 events. The treatments included in our study were Enalapril (E), Metoprolol (M), Atenolol (A), Bisoprolol (Bi), Bucindolol (Bu), Carvedilol (C), Metoprolol (M), Nebivolol (N) and placebo (P). All beta-blockers versus placebo were effective in reducing mortailty in HF and reduced ejection fraction patients. Carvedilol ranked the highest with a Surface Under the Cumulative RAnking curve (SUCRA) score of 0.8672, Atenolol was second with score of 0.7035. SUCRA scores for other drugs were: Bisoprolol 0.6897, Metoprolol 0.6139, Nebivolol 0.3704, Bucindolol 0.3519, Enalapriol 0.2635 and Placebo 0.1399. The odds ratios for Carvedilol and Atenolol versus placebo were 0.56 (0.43 – 0.71) and 0.54 (0.15 – 1.87), respectively. CONCLUSIONS: Network meta-analysis shows that Carvedilol ranks highest among beta-blockers for reduction in mortality in patients with heart failure and reduced ejection fraction.