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Background Trastuzumab is used widely for the treatment of early and advanced breast cancer.However, concerns have arisen regarding its cardiac toxicity.We did a systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess the overall risk of cardiac dysfunction associated with trastuzumab treatment.Methods We searched PubMed and Web of Science (January 1966 to July 2009) and American Society of Clinical Oncology conferences held (January 2000 to July 2009) for relevant articles and abstracts.Summary incidence rates, relative risks (RRs), and 95% confident intervals (CIs) were calculated using a fixed-effects or random-effects model.