Heart failure (HF) is a common severe non-malignant complication in childhood cancer survivors (CCS). We performed a systematic review to identify, critically appraise and synthesize population-based studies reporting on the incidence and/or prevalence of HF in 5-year CCS (age <18 years). A comprehensive literature search was carried out until March 14 th, 2023, yielding 3883 records, of which four were found eligible. Screening, data extraction, and quality assessment were conducted independently by two reviewers. A meta-analysis of three similar studies found a cumulative incidence of 0.99% (95% CI 0.57–1.42) over 5.0-72.5 years (I-squared=94.4%, p<0.001). Existing population-based studies reporting on HF in 5-year CCS are few and heterogeneous. Further studies are required to enable the development of effective surveillance strategies.