Purpose <p>With the advent of digital health interventions, internet-based cardiac rehabilitation (iCR) programs have emerged as a promising avenue for managing chronic heart disease. However, the effectiveness of iCR in improving key health outcomes remains uncertain. This study aimed to review and analyze the impact of iCR on all-cause mortality, smoking prevalence, lipid profiles, blood pressure, and BMI in patients with chronic heart disease.</p> Review methods <p>A comprehensive electronic search across Scopus, EMBASE, Medline Ovid, Chinese databases, Cochrane library, and ClinicalTrials.gov was conducted from the inception of each database until March 2024 to identify randomized controlled trials comparing iCR to standard care. Meta-analysis was performed using a random-effects model and reported as pooled risk ratio (RR) for dichotomous outcomes and standardized mean difference (SMD) in continuous outcomes. Heterogeneity was assessed through I² statistics, and publication bias was evaluated using funnel plots and Egger’s test.</p> Results <p>21 studies were included. The pooled estimates showed no significant effect of iCR on all-cause mortality (RR = 0.784), smoking cessation (RR = 0.993), total cholesterol (SMD = -0.081), HDL (SMD = -0.089), LDL (SMD = 0.031), systolic blood pressure (SMD = 0.201), diastolic blood pressure (SMD = 0.240), or BMI (SMD = -0.098). Significant heterogeneity was observed in several outcomes, and evidence of publication bias was noted in the analysis of systolic blood pressure.</p> Summary <p>iCR programs did not significantly impact the cardiovascular risk factor related health outcomes in patients with chronic heart disease. However, further research on individual types of iCR is required to identify any specific iCR that has a positive impact on patients with chronic heart disease.</p>