Background Individuals with cardiovascular disease (CVD) report psychological distress and poor physical functioning and may benefit from mindfulness training. Purpose To examine the effects of mindfulness-based interventions (MBIs) on psychological and physiological measures in adults with CVD using meta-analysis. Methods Comprehensive searches identified studies that (a) evaluated MBIs in adults with CVD or who had experienced a cardiac event, (b) included a comparison condition, and (c) assessed psychological (e.g., anxiety and depression) or physiological (e.g., systolic or diastolic blood pressure [BP]) outcomes. Independent raters coded methodological (e.g., design and quality) and intervention features (e.g., intervention content) as potential moderators. Weighted mean effect sizes (d+), using full information maximum likelihood estimation, were calculated. Results Of the 1,507 records reviewed, 16 studies met inclusion criteria (N  =  1,476; M age  =  56  years; 40% women). Compared to controls, participants who received an MBI reported greater improvements in psychological outcomes (i.e., anxiety, depression, distress, and perceived stress: d+s = 0.49 to 0.64). MBI recipients also reduced their systolic (d+ = 0.89, 95% confidence interval [CI] = 0.26, 1.51; k = 7) but not diastolic (d+ = 0.07, 95% CI = −0.47, 0.60; k = 6) BP relative to controls. Conclusions MBIs demonstrated favorable effects on psychological and physiological outcomes among adults with CVD. Future research should investigate if such benefits lead to improvements in disease outcomes in studies with longer follow-ups.