BACKGROUND: Chemotherapy-induced cardiotoxicity is the leading cause of non-tumor-related mortality among patients with tumors. Although sodium glucose cotransporter 2 inhibitors (SGLT2is) have been shown to confer cardiovascular benefits, their effects and safety profile in patients with cancer remain uncertain. The objective of this study was to assess the cardiovascular effects of SGLT2is in patients with cancer. OBJECTIVE: We conducted a meta-analysis of cohort studies to compare the efficacy and safety of SGLT2is and placebo in patients with cancer. RESULTS: A total of ten cohort studies, encompassing 85,185 patients, were included in this study. SGLT2is significantly decreased mortality (Risk ratios (RR) 0.52, 95% confidence interval (CI) (0.36, 0.75), I = 98%), heart failure (HF) (RR 0.43, 95% CI 0.24, 0.77, = 75%), and arrhythmia (RR 0.33, 95% CI 0 .23, 0.49, I = 0%). In addition, SGLT2is decreased the incidence of adverse events. No significant difference was identified in hypoglycemia, ketoacidosis, and acute coronary syndrome (ACS). CONCLUSION: The present study suggest that sodium glucose cotransporter 2 inhibitors may be an efficacious and safe means for improving the prognosis of patients with cancer and diabetes. However, future large-scale randomized controlled trials are needed to further validate the results.