Purpose: To investigate the effects of exercise training (including aerobic, resistance, and combined aerobic and resistance exercise) on exercise capacity and upper/lower extremity muscle strength in heart transplant patients by a meta-analysis. Relevance: Most of the studies on exercise training effects in heart transplant patients were relatively small in sample size. This meta-analysis was conducted to provide more evidence for exercise intervention. Participants: Only randomized controlled trials (RCTs) with exercise intervention versus control or usual care were considered in this meta-analysis regardless of the type of exercise training. Aerobic exercise, resistance exercise, or combined exercises, or any form of exercises mentioned above as a part of a multidisciplinary treatment were included and the language was limited to English or Chinese. Outcome measures of this study were peak oxygen consumption and muscle strength of upper and/or lower extremities. A total of six studies from 1998 to 2009 were included, with 117 patients in the part of peak oxygen consumption analysis (aged 55.3±9.4 years) and 67 in the analysis of upper/lower muscle strength (aged 55.9±8.3 years); 85% of them were males. Methods: A systematic searching strategy was adopted from online electronic databases, including Ovid Medline, PubMed, CINAHL, Web of Knowledge, PEDro, the Cochrane Library, and Chinese Electronic Periodical Services (CEPS) and hand searching the reference lists of the retrieved articles up to June 30, 2010. Searching keywords included heart transplantation-related medical subject heading (MeSH) keywords and exercise-related MeSH keywords. Study quality was rated by PEDro scale by two independent reviewers; only those ≥4 were included. Analysis: Mean and standard deviation for the variables of interest were retrieved from each study. Data were pooled to obtain overall effect size, 95% confidence interval (CI), and level of significance by using RevMan 5.0 (The Nordic Cochrane Centre, Denmark). Post-intervention net difference between groups was compared and a weighted mean difference (WMD) and 95% CI were calculated. A test of heterogeneity (I2)was carried out to determine whether a random or fixed effect model was applied; random effect model was used when p value of I2 < 0.05. Results: Of six studies with RCT design, two used aerobic exercise, two used resistance exercise, and the other two studies used combined exercise in their training programs. Four studies reported peak oxygen consumption, and three studies reported upper/lower extremity muscle strength. The exercise training was prescribed by intensity at 60-80% peak oxygen consumption, 11-14 of Borg score, or ≥50% of 1 repetition maximum (1-RM). Peak oxygen consumption was significantly increased by 2.30 ml/kg/minute (95% CI 0.58-4.02). The 1-RM of chest-press and leg-press was significantly improved (WMD 23.28 kg, 95% CI 0.64-45.91, and WMD 28.84 kg, 95% CI 5.70-51.98, respectively). Conclusions: Exercise training has a significant favorable change on peak oxygen consumption and upper/lower extremity muscle strength. Further high quality, large scale, and randomized trials are needed for this patient population. Implications: Exercise training, including aerobic and/or resistance exercise, should be implemented in heart transplant patients to improve their exercise capacity and muscle strength.