Objective: To assess the efficacy of Tai Chi (TC) in patients with myocardial infarction and provide up-to-date evidence for its application. Data sources: Three English databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and 3 Chinese databases (China Knowledge Resource Integrated, Wanfang, Weipu) were screened for the time period between January 1, 1976 and May 31, 2019. Study selection: Seven randomized and controlled experiments were included. Data extraction: Two independent researchers under 2 independent advisors extracted and classified the data from all relevant studies based on the prespecified inclusion criteria and rules for data extraction. Data synthesis: A total of 615 patients were included in this study. The TC group was comprised of 294 patients, and the control group included 261 patients. The results revealed that TC has significant effects on the outcomes of the 6-minute walk (standardized mean difference, 1.30; 95% confidence interval, 0.50-2.11) and left ventricular ejection fraction (standardized mean difference, 1; 95% confidence interval, 0.43-1.57) compared with no or low-density exercise. Also, TC positively affected the quality of life, pro-B type natriuretic peptide, and short form-36. However, TC did not significantly affect activities of daily living (P=.060), sense of coherence-13 (P=.057) and N-terminal-pro-brain natriuretic peptide (P=.081). A moderate to high heterogeneity was observed across all comparisons. Conclusions: Compared with no exercise or other types of low-intensity physical activities, TC improved the outcome of the 6-minute walk, left ventricular ejection fraction, quality of life, and short form-36 scores, but reduced the outcome of pro-B type natriuretic peptide in patients with myocardial infarction. Therefore, TC could be an effective exercise option for cardiac rehabilitation. More research should be done to identify the effects of TC on academic functioning and to determine ways of motivating patients to use preventive TC interventions.