The objective of the study was to determine whether dopexamine alters in-hospital mortality. The following databases were searched, Embase (1974–July 2007), Medline (1950–July 2007), CINAHL, PubMed and Cochrane Clinical Register of Controlled Trials (CENTRAL). Two reviewers independently checked the quality of the studies and extracted data. Six randomised controlled trials totalling 935 patients were included. Mortality was not significantly different with dopexamine treatment (relative risk 0.75, 95% confidence interval 0.48–1.18, p = 0.22). In conclusion, dopexamine does not improve in-hospital mortality in patients undergoing major abdominal surgery and in the critically ill.