The authors sought to conduct a systematic review comparing the effects of exercise training in heart failure patients taking β-blockers vs those not. A systematic search of exercise training trials in chronic heart failure patients that compared groups who took β-blocker medication or compared selective and nonselective β-blockers during exercise training was conducted. Eight prospective studies met the criteria for the quantitative synthesis, which included data from 236 participants. The increment in peak oxygen consumption (VO2) was greater in exercising vs control participants, with a mean difference (MD) of 1.27 mL/kg/min (95% confidence interval [CI], 0.85–1.70; P<.00001). In exercising patients, the increment in peak VO2 was greater in the group taking β-blocker vs those taking placebo (MD, 1.66 mL/kg/min; 95% CI, 0.36–2.97; P=.01). In exercising patients, there was no difference in the increment of peak VO2 between nonselective β-blocker and selective β-blockers groups (MD, −0.09 mL/kg/min; 95% CI, −1.54–1.36; P=.09). Minnesota Quality of Life Score was significantly better in the exercise group vs sedentary control group (both groups taking β-blockers) (MD, −11.3; 95% CI, −15.9 to −6.8; P<.00001). Our analysis demonstrated that β-adrenergic blocker therapy did not reduce exercise capacity or exercise training adaptations and quality of life in heart failure patients.