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.