Objective To systematically evaluate the clinical efficacy of metoprolol succinate combined with trimetazidine on coronary heart disease(CHD) and heart failure. Methods Relevant randomized controlled trials(RCT) were searched from the databases of “CNKI”, “Wanfang”, “Weipu”, “Longyuan”, etc with the key words of “coronary heart disease”, “heart failure”, “Metoprolol Succinate”, “Trimetazidine”, eleven articles were included Finally. Throught evaluating quality of the literature, relevant indicators including total effective rate, systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR), left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), left ventricular ejection fraction(LVEF), plasma brain peptide urinary peptide(BNP), incidence of adverse reactions were performing for systematic analysis. Results The total effective rate in the observation was significantly higher than that in the control group (OR=3.70, 95%CI: 2.16-6.33, Z=4.76, P<0.01); Compared with the control group, SBP, DBP, HR, LVEDD, LVESD and BNP in the observation group were significantly lower (P<0.05); LVEF percent in the observation group was significantly higher (MD=4.07, 95%CI: 1.60-6.55, Z=3.22, P=0.0001); incidence of adverse reactions in the observation group was significantly lower (OR=0.12, 95%CI: 0.06-0.24, Z=6.11, P<0.01). Conclusion Using Metoprolol Succinate combined with Trimetazidine on CHD and heart failure can effectively improve the cardiopulmonary function of patients. The clinical effect is better than conventional treatment with higher safety of medication.