Supraventricular tachyarrhythmias, especially atrial fibrillation, are associated with a substantial mortality, morbidity and economic importance. The present systematic review examined the effectiveness of esmolol in the treatment of supraventricular tachyarrhythmias. Altogether 14 trials with 692 patients were included into meta-analysis. Esmolol is more effective to rate control than rhythm control. It has been found that esmolol can effectively reduce increases in heart rate and systolic blood pressure compared to placebo. In comparison to other drugs there were no significant differences. The most prevalent adverse effect during administration of esmolol were hypotension and bradycardia.