Objective To investigate the efficacy of His bundle pacing in patients with heart failure via a meta-analysis. MethodsDatabases (Cochrane Library, PubMed, Embase, Wanfang Database, VIP Database, CNKI Database, Sinomed) were searched to select the studies that meet the inclusion criteria and evaluate the efficacy of His bundle pacing in patients with heart failure. Data were collected and analyzed of QRS duration, left ventricular ejection fraction, pacing threshold at baseline and follow-up. Analysis was performed using Stata 12.0. Results A total of 14 studies were included, enrolling 539 patients with heart failure (mean age:70.9 years). Meta-analysis showed that His bundle pacing significantly shortened the QRS duration (WMD=-51.51ms, 95%CI =-59.50 to -43.52, P<0.01) and improved left ventricular ejection fraction (WMD=10.91%, 95%CI=7.55 to 14.27, P<0.01). However, compared with baseline, His bundle capture threshold tended to be higher (WMD=0.26V, 95%CI=0.15 to 0.36, P<0.01). Conclusion His bundle pacing can significantly improve cardiac function in patients with heart failure. More large-scale clinical randomized controlled trials are needed in the future to confirm the efficacy of His bundle pacing in such patients.