Background Heart failure clinics (HFC) are an integral aspect of the strategy for community heart failure care. Methods A systematic search was conducted to retrieve studies. We searched for candidate articles in the Pubmed, EMBASE, and Cochrane databases from 1990 to January 2017. Results 16 RCTs were included in the meta-analysis with 3999 patients. HFC group had a lower incidence of the primary composite endpoint of heart failure hospitalization and all-cause mortality (OR 0.58, p=0.0003). The benefit was maintained when stratified according to non-nurse led HFC (OR 0.52, p=0.003), clinics which followed-up patients ≥ 3 months (OR 0.51, p=0.0009), patients with mean ejection fraction ≤30% (OR 0.39, p=0.02) and ejection fraction >30% (OR 0.72, p=0.02), and patients with recent hospitalization for heart failure (OR 0.51, p=0.0001). There was no benefit in patients who were seen in HFC with limited follow-up ≤ 3 months (OR 0.91, p=0.69), patients with stable heart failure without recent hospitalization (OR 0.95, p=0.70), and studies published after 2008 (OR 0.89, p= 0.31). Patients in the HFC group had lower HF hospitalization (OR 0.68, p=0.003) however no significant difference in all-cause hospitalization (OR 1.04, p=0.33). There was lower all-cause mortality in the HFC group (OR 0.71, p=0.006). Conclusions The results of our analysis show a benefit of HFC to reduce HF hospitalization, and all-cause mortality. This was a cumulative benefit of all randomized clinical trials assessing the benefit of HFC, with additional analysis demonstrating a greater benefit among patients with recent emergency room visit or hospitalization, and patients seen frequently in follow-up ≥ 3 months.