Purpose: This systematic review aimed to evaluate the effectiveness of virtual reality (VR) technology in cardiac rehabilitation (CR) patients, focusing on cardiopulmonary function, quality of life, adherence, and satisfaction. Methods: Conducted following PRISMA guidelines and registered on PROSPERO (CRD42025643632), this study systematically searched PubMed, Web of Science, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, CNKI, and Wanfang Data. Meta-analysis was performed using RevMan 5.4 to assess the impact of VR interventions on cardiopulmonary function, quality of life (QOL), adherence, and satisfaction compared to conventional CR programs. Results: Twenty studies were included. Meta-analysis revealed that VR improved the 6 min walk test distance (MD: 34.9, 95% CI: 24.43, 45.37; p < 0.00001, I² = 67%) and QOL (SMD: 0.63, 95% CI: 0.09, 1.17; p = 0.002, I² = 86%). However, evidence regarding adherence and satisfaction was inconclusive. Conclusions: VR technology outperforms traditional CR in enhancing cardiopulmonary function and quality of life. While it might improve patient adherence, further research is necessary to confirm these findings.