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Patients with cardiovascular disease (CVD) often rely on informal caregivers to promote healthy dietary intake and compliance. Dyadic interventions show potential for enhancing patients' healthy diets, yet the effectiveness remains unexplored. A systematic review and meta-analysis were conducted. PubMed, Cochrane Library, Embase, CINAHL Plus, PsycINFO, and Web of Science were searched up to January 10, 2025. This review included 29 articles (i.e., 25 studies) involving 3039 patients and 2706 caregivers. Dyadic interventions significantly reduced patients' sodium intake, fat intake, body mass index, and improved self-care behavior, quality of life, heart disease knowledge, self-efficacy, and perceived support. However, the interventions did not improve patients' blood lipid profiles. Insufficient studies prevented meta-analyses for patients' blood pressure and blood sugar levels, health motivation, communication, mutuality, caregivers' self-care behavior, disease knowledge, quality of life, self-efficacy/caregiver mastery, and caregiver burden. Dyadic interventions showed preliminary evidence for improving CVD patients' diets. High-quality dyadic research is needed to validate current findings, assess the effectiveness on other dietary outcomes, and explore effective intervention characteristics. Trial Registration: PROSPERO number: CRD42023473308 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=473308).