Post-cardiac surgery chylopericardium is a rare complication. This systematic review included 87 articles with 119 patients of post-cardiac surgery chylopericardium. Chylopericardium developed after operations for congenital heart defect more than those for acquired heart disease, and more patients in whom post-cardiac surgery chylopericardium developed were with complex than with simple congenital heart defects. Cardiac tamponade occurred in 35 (29.4%) patients. The onset time of chylopericardium was 18.2 days earlier in patients operated for acquired than in those for congenital heart defects. Post-cardiac surgery chylopericardium were curable to conservative treatment in most patients. The recurrence of post-cardiac surgery chylopericardium was on day 13.2 ±18.2 after the initial treatment. The overall early and late mortality rates were 1.7% (2/119) and 1.7% (2/117), respectively. Most patients with post-cardiac surgery chylopericardium were diagnosed by laboratory analysis of chylous uid. Patients with mild chylopericardium usually show good response to conservative treatment. Whereas, patients with massive chylopericardium and rapid accumulation, incurable to conservative treatment and recurrent to either conservative or surgical treatment, warrant further surgical treatment.