This systematic review and meta-analysis were conducted to evaluate the cardiac and kidney-related adverse effects of Roxadustat for the treatment of anemia in CKD patients. 17 trials with a total of 6673 participants were identified for analysis. Meta-analysis revealed no significant difference in the risk of occurrence of cardiac disorders when comparing CKD patients receiving Roxadustat with the placebo group (RR=1.049; CI [0.918 to 1.200]) or ESA (RR = 1.099; CI [0.907 to 1.331]) group, in both dialysis-dependent (DD) (RR = 1.181; CI [0.925 to 1.507]) or non-dialysis-dependent (NDD) (RR = 1.036; CI [0.916 to 1.171]) CKD patients. No significant difference was observed in the risk of kidney-related adverse events when comparing groups receiving Roxadustat with the placebo group (RR=1.088; CI [0.980 to 1.209]) or ESA group (RR = 0.968; CI [0.831 to 1.152]), in DD (RR = 2.649; CI [0.201 to 34.981]) or NDD (RR = 1.053; CI [0.965 to 1.149]) CKD patients. No significant risk of hyperkalemia was observed in the Roxadustat group whether in DD (RR = 1.145; CI [0.756 to 1.734]) or NDD (RR = 1.116; CI [0.930 to 1.339]) patients. Incidence of hypertension was higher in the Roxadustat group, compared to the placebo group (RR = 1.374; CI [1.153 to 1.638]). In summary, the risk of cardiac or kidney-related events observed in the Roxadustat was not significantly increase whether in DD or NDD patients. However, attention must be paid to the occurrence of hypertension in patients using Roxadustat.