A large body of evidence exist on diet and cardiovascular mortality, but limited studies have investigated the long-term intake of food groups, which may have cumulative effects on cardiovascular health in the long term. This review therefore evaluated the relationship between long-term consumption of ten food groups and cardiovascular mortality. We conducted a systematic search in Medline, Embase, Scopus, CINAHL and Web of Science up to January 2022. With a total 5,318 studies identified initially, 22 studies with a total of 70,273 participants with cardiovascular mortality were included. Summary Hazard Ratios (HR) and 95% CIs were estimated with the use of a random effects model. We found that a long-term high intake of whole grains (HR:0.87; 95% CI:0.80,0.95; P=0.001), fruits and vegetables (HR:0.72; 95% CI:0.61,0.85; P<0.0001) and nuts (HR: 0.73; 95% CI:0.66,0.81; P<0.00001) significantly reduced cardiovascular mortality. Each 10-gram increase in whole grain consumption per day was associated with a 4% reduction in the risk of cardiovascular mortality, whilst each 10-gram increase in red/processed meat consumption per day was associated with a 1.8% increase in the risk of cardiovascular mortality. Compared to the lowest intake category, red/processed meat consumption in the highest category was associated with an increased risk of cardiovascular mortality (HR:1.23; 95% CI:1.09,1.39; P=0.006). High intake of dairy products (HR:1.11; 95% CI:0.92,1.34; P=0.28) and legumes (HR:0.86; 95% CI:0.53,1.38; P=0.53) were not associated with cardiovascular mortality, but in the dose-response analysis each 10-gram increase in legume intake per week was associated with a 0.5% reduction in cardiovascular mortality. We conclude that the long-term high intake of whole grains, vegetables, fruits, nuts and low intake of red/processed meat are associated with reduced cardiovascular mortality. More data on the long-term effects of legumes on cardiovascular mortality are encouraged. This study was registered at PROSPERO as CRD42020214679.