OBJECTIVES: Heart failure (HF) is a common clinical syndrome representing the end-stage of several cardiac diseases. Our objective was to estimate the burden of heart failure in Latin America. METHODS: A systematic review and meta-analysis was performed. We searched in MEDLINE, EMBASE, LILACS, and CENTRAL from January 1994 to June 2014. We included non-comparative data from experimental and observational studies. No language restriction was imposed. We included studies with samples of at least 50 participants of 18 years of age or older with HF. The outcomes analyzed were incidence, prevalence, hospitalization rates and case fatality ratios of HF at different time points, length of stay and mortality. RESULTS: The search retrieved 4792 references of which 143 studies were finally included. Most were conducted in South America (92%), particularly in Brazil (64%). The mean age was 60 ± 9 years and the mean ejection fraction was 36 ± 9%. Most studies evaluated more than one etiology (79%) but the etiology more studies exclusively was Chagas disease (13%). The incidence of HF ranged from 199 to 557 cases per 100,000 person-years and the pooled prevalence was 1%, being higher in older populations. Hospitalization rates in patients with HF ranged from 28 to 31% at different time points, and the median length of stay was 7.0 days. In-hospital mortality was 11.7%, being higher in patients with worse ejection fraction, with ischemic and with Chagas disease. Mortality at one year was 24.52% (95%CI 19.42 to 30.02). CONCLUSIONS: This SR of HF in Latin America, could help decision-makers to design better preventive strategies, and guide effective patient-centered care.