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This study aimed to systematically review and meta-analyze the effectiveness of eHealth-based cardiovascular disease (CVD) risk communication and its impact on health-related outcomes. Twenty-three RCTs were included. The eHealth-based CVD risk communication showed significant improvements in controlling systolic blood pressure (P = 0.03), low-density lipoprotein (P = 0.02), physical activity (P = 0.003), smoking cessation (P = 0.004), disease awareness (P = 0.002), and quality of life (P = 0.03). No significant effects were found for other outcomes, including diastolic blood pressure, total cholesterol, and overall risk scores. These findings provide valuable insights into the potential role of eHealth-based risk communication in CVD prevention. In addition, existing risk communication interventions are multicomponent, and future research could standardize intervention components and optimize intervention elements using the Behavior Change Techniques Taxonomy and factorial designs, while developing targeted risk communication strategies for different populations to improve health outcomes.