OBJECTIVE To assess the efficacy and safety of edaravone for myocardial damage during myocardial ischemia and reperfusion (I/R). METHODS We included randomized controlled trials that compared edaravone with placebo or no intervention in patients with acute myocardial infarction or undergoing coronary artery bypass. Two authors selected eligible trials, assessed trial quality and independently extracted the data. RESULTS Seven clinical trials were eventually included and analyzed in this study, involving 148 participants. Four trials were defined as waiting assessment. All of the three remaining trials compared edaravone and another treatment combined with other treatment alone, used the same dose of edaravone injections (60 mg per day) and course of treatment (14 days), evaluated the effect of edaravone at different times, applied different methods, reported adverse events, and showed no differences between the treatment group and the control group. When pooling all of the trials in one dataset, edaravone appeared to decrease the proportion of participant with marked myocardial damage during I/R as compared with the control group. The meta-analysis also revealed decreased CK-MB, cTnI and MDA, and increased content of SOD. CONCLUSIONS Due to the moderate risk of bias and small sample, our observation of an effective treatment trend of edaravone for I/R requires future larger, high-quality trials to confirm.